H-Index
38
Scimago Lab
powered by Scopus
JCR
Clarivate
Analytics
call: +1.631.629.4327
Mon-Fri 10 am - 2 pm EST

Logo

MSMbanner
Medical Science Monitor Basic Research

AmJCaseRep
MedSciTechnol

eISSN: 2329-0358

Get your full text copy in PDF

Endoscopic Treatment of Early Biliary Complications in Liver Transplant Recipients

Konrad Kobryń, Sławomir Kozieł, Marta Poręcka, Krzysztof Kobryń, Wacław Hołówko, Waldemar Patkowski, Krzysztof Zieniewicz, Tadeusz Wróblewski, Marek Krawczyk

(Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland)

Ann Transplant 2015; 20:741-746

DOI: 10.12659/AOT.896786


BACKGROUND: The most common complications following liver transplantation (LTx) concern the biliary ducts. Potential early complications are biliary leaks and anastomotic strictures of the bile duct. The aim of this study was to evaluate the efficacy of endoscopic treatment of early biliary complications in liver transplant recipients after end-to-end biliary anastomosis.
MATERIAL AND METHODS: From January 2011 to December 2013, 475 patients underwent LTx at our Department. There were 101 endoscopic procedures performed in total during this period, out of which 67 were related to biliary complications in 44 patients, while the remaining procedures were carried out due to gastrointestinal bleeding. We established a timeframe of up to 3 months postoperatively as the early biliary complication period. With the selected criteria we retrospectively analyzed medical records of 24 liver recipients who underwent endoscopic treatment due to early biliary complications. The outcome of endoscopic treatment was statistically analyzed and categorized as a technical and clinical success.
RESULTS: During this period there were 38 endoscopic procedures in the analyzed group of patients treated due to early biliary complications. The results were: successful balloon dilation alone was performed in 2 patients with no further need of treatment, implantation of plastic stents was performed initially in 13 patients, but 7 patients required further stenting with larger caliber plastic stents (PS). Self-expandable metal stents (SEMS) were initially placed in 7 patients during this period overall. One patient was treated due to hemobilia. In 1 case endoscopic retrograde cholangiopancreatography (ERCP) was unfeasible and the patient required surgical intervention. In 1 case a PS was exchanged for an SEMS. Six patients with satisfactory cholangiography images had the stent removed during the second ERCP.
CONCLUSIONS: In consideration of the stabilized rate of biliary complications following LTx, an advanced transplant center cannot function without an experienced endoscopist. For early biliary leaks and anastomotic strictures, ERCP is the primary treatment.

Keywords: Anastomosis, Roux-en-Y, Biliary Fistula, Cholangiopancreatography, Endoscopic Retrograde, Cholangitis, Sclerosing, Hepatitis, Autoimmune, Liver Transplantation

This paper has been published under Creative Common Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) allowing to download articles and share them with others as long as they credit the authors and the publisher, but without permission to change them in any way or use them commercially.
I agree