Uncommon Biliary Complications in Liver Transplant Recipients: an Observational Analysis Over 16 Years

Aims Biliary complications are an important cause of morbidity and mortality in liver transplant (LT) recipients. The majority of these complications are due to strictures and leaks. However, other less frequent complications, such as papillary stenosis, biloma, hemobilia and functional biliary sphincter disorder (FBSD), have been poorly studied. The aim of this analysis is to describe the prevalence, risk factors and outcome of these infrequent biliary complications.

Methods We reviewed all endoscopic retrograde cholangiopancreatographies (ERCP) performed in LT recipients from 01/2003 to 12/2020. We included all LT patients with duct-to-duct anastomosis that developed biliary complications. Information on clinical and endoscopic findings was obtained from electronic health records and endoscopy databases.

Results 911 ERCP’s were performed in 332 LT patients during the study period. Of these, 303 had post-LT biliary complications, while 29 patients presented non-biliary complications (i.e pancreatitis, pancreatic stones), 73 % were men with a mean age of 64, 23 ±10,86 years. Two hundred forty-two patients (80 %) had common complications (anastomotic/non-anastomotic strictures, biliary leaks and biliary stones or sludge). Sixty-one patients (20 %) presented uncommon complications such as papillary stenosis, bilomas, hemobilia and biliary casts. Underlying liver disease was HCV in 48 %, alcohol (17 %), HBV (9 %), fulminant hepatitis (8 %), primary biliary cirrhosis (3 %) and primary sclerosing cholangitis (0.4 %). Age, gender, type of transplant, and underlying liver disease were compared between patients with common complications and uncommon complications. No significant differences were observed between the two groups. Interestingly failed cannulation was observed in 7 % of patients in common biliary complications group vs 36 % of patients with uncommon biliary complications (p<0.01).

Conclusions Approximately 20 % of LT recipients develop uncommon biliary complications. No significant differences in risk factors or outcome were found between patients with common and uncommon biliary complications after LT.

Citation: Fernandez-Simon A, Vilagrasa-Vilella A, Bofill A et al. OP114 UNCOMMON BILIARY COMPLICATIONS IN LIVER TRANSPLANT RECIPIENTS: AN OBSERVATIONAL ANALYSIS OVER 16 YEARS. Endoscopy 2021; 53: S48.

Publication History

Article published online:
19 March 2021