Traumatic Neuroma of Extrahepatic Bile Ducts After Orthotopic Liver Transplantation

Traumatic biliary neuroma after orthotopic liver transplantation: a possible cause of “unexplained” anastomotic biliary stricture

“…Due to its large surrounding innervation, the division of the common bile duct may trigger such inappropriate regeneration and thus result in the development of neuroma. The latter has been well described after various biliary surgical procedures, such as cholecystectomy, but data regarding its occurrence after OLT remain scarce …”

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“…In the first, the authors described 15 patients with TBN in a series of 428 OLT patients; the incidence of symptomatic and histologically proven TBN was 3.5%. 4 The other series described 5 patients with TBN out of 52 patients who developed an anastomotic biliary stricture after OLT. All 5 patients with TBN had a duct-to-duct biliary reconstruction during OLT and subsequent repeated surgical procedures.…”

“…The patient underwent retransplant 63 months after the original procedure. 4 The clinical and imaging features of TBN are usually nonspecific; the only valid diagnostic modality is histologic analysis. Because of the move toward conservative treatment of late biliary strictures, many patients are no longer treated surgically, and a true assessment of the incidence of TBN is impossible.…”

Hilar traumatic neuroma masquerading as Klatskin tumor

“…5 Bile duct neuroma was demonstrated in up to 10% of post cholecystectomy patients at autopsy in one study. 6 Common bile duct exploration has also been associated with neuroma formation. Traumatic neuromas (TN) of the biliary tree causing strictures have also been reported after liver transplantation.…”

“…Traumatic neuromas (TN) of the biliary tree causing strictures have also been reported after liver transplantation. 6 Hilar traumatic neuroma is very rare.…”