Management of biliary problems after liver transplantation

Möser, Michael; Wall, William

doi:10.1053/jlts.2001.28518

Cited by 110 publications

(98 citation statements)

References 37 publications

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“…IBL was found in 17 (24.3%) of our patients, 11 (64.7%) presented early within 1 mo while 5 (35.3%) manifested within 3 mo post OLT. ERC plus placement of biliary endoprosthesis with or without endoscopic sphincterotomy has been shown to achieve a success rate of over 90% [7,27,28] in treating IBL. We failed to treat bile leakage in 1 patient (success rate 95.5%) while 3 other patients were shown to have complete dissociation and necrosis of common bile duct on ERC, hence were not considered for endoscopic therapy.…”

Section: Discussionmentioning

confidence: 99%

Liver biochemistry profile, significance and endoscopic management of biliary tract complications post orthotopic liver transplantation

Shastri

Hoepffner²,

Akoglu³

et al. 2007

WJG

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AIM:To correlate the significance of liver biochemical tests in diagnosing post orthotopic liver transplantation (OLT) biliary complications and to study their profile before and after endoscopic therapy. METHODS:Patients who developed biliary complications were analysed in detail for the clinical information, laboratory tests, treatment offered, response to it, follow up and outcomes. The profile of liver enzymes was determined. The safety, efficacy and outcomes of endoscopic retrograde cholangiography (ERC) were also analysed.RESULTS: 40 patients required ERC for 70 biliary complications. GGT was found to be > 3 times (388.1 ± 70.9 U/mL vs 168.5 ± 34.2 U/L, P = 0.007) and SAP > 2 times (345.1 ± 59.1 U/L vs 152.7 ± 21.4 U/L, P = 0.003) the immediate post OLT values. Most frequent complication was isolated anastomotic strictures in 28 (40%). Sustained success was achieved in 26 (81%) patients. CONCLUSION:Biliary complications still remain an important problem post OLT. SAP and GGT can be used as early, non-invasive markers for diagnosis and also to assess the adequacy of therapy. Endoscopic management is usually effective in treating the majority of these biliary complications.

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Section: Discussionmentioning

confidence: 99%

Liver biochemistry profile, significance and endoscopic management of biliary tract complications post orthotopic liver transplantation

Shastri

Hoepffner²,

Akoglu³

et al. 2007

WJG

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“…(5) Diffuse biliary strictures often present as part of the picture of biliary tree damage after an ABO-incompatible transplantation. 87 However, intrahepatic strictures may occur in the absence of arterial thrombosis, rejection, or ABO-incompatible grafting, and the late appearance of intrahepatic strictures may indicate disease recurrence in patients who received a transplant for primary sclerosing cholangitis. 87 The diagnosis is based on dilated intrahepatic bile ducts on ultrasound or computed tomography and cholangiography (percutaneous transhepatic cholangiography or endoscopic retrograde or magnetic resonance cholangiopancreatography; Fig.…”

Section: Late Intrahepatic Cholestatic Syndrome Intrahepatic Biliary mentioning

confidence: 99%

“…Main etiologic factors that should be considered 12,13,87 are (1) Arterial occlusion (late hepatic artery thrombosis). (2) Biliary injury from prolonged cold preservation: ischemic times in excess of 12 hours significantly increase the risk.…”

Section: Late Intrahepatic Cholestatic Syndrome Intrahepatic Biliary mentioning

confidence: 99%

Intrahepatic cholestasis after liver transplantation

Ben‐Ari

Pappo

Mor

2003

Liver Transplantation

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Cholestasis is a common sequela of liver transplantation. Although the majority of cases remain subclinical, severe cholestasis may be associated with irreversible liver damage, requiring retransplantation. Therefore, it is essential that clinicians be able to identify and treat the syndromes associated with cholestasis. In this review, we consider causes of intrahepatic cholestasis. These may be catego-

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“…1,2 The incidence of biliary complications is greatest in the first few months after transplantation with the frequency decreasing after the first post-transplantation year. 3 Biliary complications include anastomotic strictures (AS), non-anastomotic bile duct stricture (NAS), stone formation, bile leak, biloma, biliary necrosis, sphincter of Oddi dysfunction (SOD), cholangitis, hemobilia, recurrent malignancy, and post-transplantation lymphoproliferative disorder. The etiology of biliary complications is multifactorial.…”

mentioning

confidence: 99%

Post-liver Transplant Biliary Complications

Atwal¹,

Pastrana²,

Sandhu³

2012

Journal of Clinical and Experimental Hepatology

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Biliary tract complications remain a common source of morbidity and mortality in liver transplant (LT) recipients with an estimated incidence of 5-30% after orthotopic LT and a mortality rate of up to 10%. Biliary complications after LT may be related to various factors including hepatic artery thrombosis or stenosis, ischemia reperfusion injury, immunologic injury, infections, donor pool, and technical issues which include imperfect anastomosis and T-tube-related complications. Management of the detected biliary complications includes nonsurgical and surgical methods. A majority of these post transplant biliary complications can be treated with endoscopic retrograde cholangiography. If unsuccessful, a percutaneous intervention or surgery may be required. In this article, we review the incidence, clinical presentation, and management of the main types of biliary complications. (J CLIN EXP HEPATOL 2012;2:81-85)

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Management of biliary problems after liver transplantation

Cited by 110 publications

References 37 publications

Liver biochemistry profile, significance and endoscopic management of biliary tract complications post orthotopic liver transplantation

Liver biochemistry profile, significance and endoscopic management of biliary tract complications post orthotopic liver transplantation

Intrahepatic cholestasis after liver transplantation

Post-liver Transplant Biliary Complications

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