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Endoscopy 2005; 37(9): 857-863
DOI: 10.1055/s-2005-870192
The Expert Approach Section
© Georg Thieme Verlag KG Stuttgart · New York

Biliary Complications after Liver Transplantation: the Role of Endoscopy

P.  J.  Thuluvath1 , P.  R.  Pfau2 , M.  B.  Kimmey3 , G.  G.  Ginsberg4
  • 1Dept. of Medicine, Johns Hopkins University School of Medicine, Johns Hopkins Hospital, Baltimore, Maryland, USA
  • 2Dept. of Medicine, University of Wisconsin Medical School, Madison, Wisconsin, USA
  • 3University of Washington Medical Center, Seattle, Washington, USA
  • 4Division of Gastroenterology, University of Pennsylvania Health System, Philadelphia, Pennsylvania, USA
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Publication History

Publication Date:
22 August 2005 (online)

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Abstract

Biliary complications are important causes of early and late postoperative morbidity and mortality after liver transplantation and are seen in 10 - 20 % of the patients. The common biliary complications include bile leaks, stones or debris, and anastomotic strictures. Less common complications are hilar strictures, intrahepatic strictures, and papillary stenosis/dysfunction. The complications are similar in living-donor and cadaveric liver transplantations, except for a higher incidence of bile leaks among living-donor transplant recipients. The clinical presentation of post-liver transplant bile duct complications is often subtle, and noninvasive imaging studies may sometimes fail to detect mild but clinically significant stenoses or small leaks. Early recognition and prompt treatment of biliary complications following liver transplantation reduces the morbidity and improves long-term graft and patient survival. In this report, we discuss the role of endoscopy in the diagnosis, treatment options, and the outcome for patients with biliary complications following liver transplantation.

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P. J. Thuluvath, M.D., F.R.C.P.

The Johns Hopkins University School of Medicine

1830 East Monument Street · Baltimore, MD 21205 · USA

Fax: +1-410-614-9612

Email: pjthuluv@jhmi.edu