Successful treatment of complex cholangiolithiasis following orthotopic liver transplantation with interventional radiology

Abstract

Bile duct stones are a serious and the third most common complication of the biliary system that can occur following liver transplantation. The incidence rate of bile duct stones after liver transplantation is 1.8%-18%. The management of biliary stones is usually performed with endoscopic techniques; however, the technique may prove to be challenging in the treatment of the intrahepatic bile duct stones. We herein report a case of a 40-year-old man with rare, complex bile duct stones that were successfully eliminated with percutaneous interventional techniques. The complex bile duct stones were defined as a large number of bile stones filling the intra- and extrahepatic bile tracts, resulting in a cast formation within the biliary tree. Common complications such as hemobilia and acute pancreatitis were not present during the perioperative period. The follow-up period was 20 mo long. During the postoperative period, the patient maintained normal temperature, and normal total bilirubin and direct bilirubin levels. The patient is now living a high quality life. This case report highlights the safety and efficacy of the percutaneous interventional approach in the removal of complex bile duct stones following liver transplantation.

Percutaneous removal of biliary stones post‐liver transplant in a pediatric patient: Case report and review of the literature

“…This study indicated that bile leaks and bile stones comprise 82.4% of biliary complications following LT 11 . One study found that the incidence of bile duct stones following LDLT was 10%, while another reported an incidence range of 1.8%‐18% 12,13 …”

“…The technique of percutaneous transhepatic management of biliary stones has been reported as successful in children in the non‐LT setting 26,27 . In the setting of LT, one case report concerning a 40‐year‐old man with complex bile stones in the intra‐ and extra‐hepatic bile tracts indicated that a percutaneous interventional approach was utilized successfully in extracting the stones, with no complications post‐procedure 13 …”

The Structural Bile Ducts Organization in the Pathological Conditions

“…Пошкодження епітелію слизової оболонки жовчних проток, зумовлене аутоімунним дисбалансом, вірусною чи бактеріальною інфекцією, токсичними речовинами чи аномаліями розвитку, призводить до важких структурних змін печінки, обумовлюючи високу смертність [3]. Особливу увагу дослідники зосереджують на терапевтичному та хірургічному лікуванні патології жовчних проток (гострий та хронічний холангіт [4,5], гнійний холангіт і холєдохолітіаз [6][7][8][9][10][11], непрохідність жовчних проток [12]). Кількість оперативних втручань на жовчних протоках за останні 10 років зросла на 56 % (близько 4100 оперативних втручань у рік), при цьому післяопераційна летальність складає 2,1 % [13].…”