Download PDF
Semin intervent Radiol 2004; 21(4): 297-308
DOI: 10.1055/s-2004-861564
Copyright © 2004 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

Interventional Radiology: Management of Biliary Complications of Liver Transplantation

Nishita Kothary1 , Aalpen A. Patel2 , Richard D. Shlansky-Goldberg2
  • 1Division of Vascular and Interventional Radiology, Columbia University Medical Center, New York, New York
  • 2Department of Radiology, University of Pennsylvania School of Medicine Philadelphia, Pennsylvania
Further Information

Publication History

Publication Date:
07 January 2005 (online)

Also available at
    Permissions and Reprints

ABSTRACT

Major advances in the field of liver transplantation have led to an increase in both graft and patient survival rates. Despite increased graft survival rate, biliary complications lead to significant postoperative morbidity and even mortality. A multidisciplinary approach to these complications is critical. As part of the team approach, less invasive techniques used by the interventional radiologist have an increasing role in the management of complications after liver transplantation. This paper will review the current role of the interventionalist in management of biliary complications.

KEYWORDS

Liver transplantation - biliary - complications - biliary strictures - biliary leak - interventional radiology

REFERENCES

  • 1 Righi D, Cesarani F, Muraro E, Gazzera C, Salizzoni M, Gandini G. Role of interventional radiology in the treatment of biliary strictures following orthotopic liver transplantation.  Cardiovasc Intervent Radiol. 2002;  25 30-35
    CrossrefPubMedGoogle Scholar
  • 2 Klein A S, Savader S, Burdick J F et al.. Reduction of morbidity and mortality from biliary complications after liver transplantation.  Hepatology. 1991;  14 818-823
    CrossrefPubMedGoogle Scholar
  • 3 Greif F, Bronsther O L, Van Thiel D H et al.. The incidence, timing, and management of biliary tract complications after orthotopic liver transplantation.  Ann Surg. 1994;  219 40-45
    CrossrefPubMedGoogle Scholar
  • 4 Lopez R R, Benner K G, Ivancev K, Keeffe E B, Deveney C W, Pinson C W. Management of biliary complications after liver transplantation.  Am J Surg. 1992;  163 519-524
    Google Scholar
  • 5 Popescu I, Sheiner P, Mor E et al.. Biliary complications in 400 cases of liver transplantation.  Mt Sinai J Med. 1994;  61 57-62
    PubMedGoogle Scholar
  • 6 Park J S, Kim M H, Lee S K et al.. Efficacy of endoscopic and percutaneous treatments for biliary complications after cadaveric and living donor liver transplantation.  Gastrointest Endosc. 2003;  57 78-85
    CrossrefPubMedGoogle Scholar
  • 7 Stratta R J, Wood R P, Langnas A N et al.. Diagnosis and treatment of biliary tract complications after orthotopic liver transplantation.  Surgery. 1989;  106 675-683
    Google Scholar
  • 8 Theilmann L, Kuppers B, Kadmon M et al.. Biliary tract strictures after orthotopic liver transplantation: diagnosis and management.  Endoscopy. 1994;  26 517-522
    Article in Thieme ConnectPubMedGoogle Scholar
  • 9 Thuluvath P J, Atassi T, Lee J. An endoscopic approach to biliary complications following orthotopic liver transplantation.  Liver Int. 2003;  23 156-162
    CrossrefPubMedGoogle Scholar
  • 10 Brown Jr R S, Russo M W, Lai M et al.. A survey of liver transplantation from living adult donors in the United States.  N Engl J Med. 2003;  348 818-825
    CrossrefPubMedGoogle Scholar
  • 11 Egawa H, Inomata Y, Uemoto S et al.. Biliary anastomotic complications in 400 living related liver transplantations.  World J Surg. 2001;  25 1300-1307
    CrossrefPubMedGoogle Scholar
  • 12 Hiatt J R, Quinones-Baldrich W J, Ramming K P, Brems J, Busuttil R W. Operations upon the biliary tract during transplantation of the liver.  Surg Gynecol Obstet. 1987;  165 89-93
    PubMedGoogle Scholar
  • 13 Hardy K J, Wang B Z, Jones R M. Biliary complications after liver transplant: the Victorian experience.  Aust N Z J Surg. 1996;  66 162-165
    PubMedGoogle Scholar
  • 14 Johnson M W, Thompson P, Meehan A et al.. Internal biliary stenting in orthotopic liver transplantation.  Liver Transpl. 2000;  6 356-361
    CrossrefPubMedGoogle Scholar
  • 15 Koivusalo A, Isoniemi H, Salmela K, Edgren J, von Numers H, Hockerstedt K. Biliary complications in one hundred adult liver transplantations.  Scand J Gastroenterol. 1996;  31 506-511
    PubMedGoogle Scholar
  • 16 Kuo P C, Lewis W D, Stokes K, Pleskow D, Simpson M A, Jenkins R L. A comparison of operation, endoscopic retrograde cholangiopancreatography, and percutaneous transhepatic cholangiography in biliary complications after hepatic transplantation.  J Am Coll Surg. 1994;  179 177-181
    PubMedGoogle Scholar
  • 17 Lemmer E R, Spearman C W, Krige J E et al.. The management of biliary complications following orthotopic liver transplantation.  S Afr J Surg. 1997;  35 77-81
    PubMedGoogle Scholar
  • 18 Letourneau J G, Hunter D W, Payne W D, Day D L. Pictorial essay: imaging of and intervention for biliary complications after hepatic transplantation.  AJR Am J Roentgenol. 1990;  154 729-733
    PubMedGoogle Scholar
  • 19 Moser M A, Wall W J. Management of biliary problems after liver transplantation.  Liver Transpl. 2001;  7(suppl 1) S46-S52
    CrossrefPubMedGoogle Scholar
  • 20 Nemec P, Ondrasek J, Studenik P, Hokl J, Cerny J. Biliary complications in liver transplantation.  Ann Transplant. 2001;  6 24-28
    PubMedGoogle Scholar
  • 21 Patkowski W, Nyckowski P, Zieniewicz K et al.. Biliary tract complications following liver transplantation.  Transplant Proc. 2003;  35 2316-2317
    CrossrefPubMedGoogle Scholar
  • 22 Rerknimitr R, Sherman S, Fogel E L et al.. Biliary tract complications after orthotopic liver transplantation with choledochocholedochostomy anastomosis: endoscopic findings and results of therapy.  Gastrointest Endosc. 2002;  55 224-231
    CrossrefPubMedGoogle Scholar
  • 23 Sawyer R G, Punch J D. Incidence and management of biliary complications after 291 liver transplants following the introduction of transcystic stenting.  Transplantation. 1998;  66 1201-1207
    CrossrefPubMedGoogle Scholar
  • 24 Feller R B, Waugh R C, Selby W S, Dolan P M, Sheil A G, McCaughan G W. Biliary strictures after liver transplantation: clinical picture, correlates and outcomes.  J Gastroenterol Hepatol. 1996;  11 21-25
    PubMedGoogle Scholar
  • 25 Guichelaar M M, Benson J T, Malinchoc M, Krom R A, Wiesner R H, Charlton M R. Risk factors for and clinical course of non-anastomotic biliary strictures after liver transplantation.  Am J Transplant. 2003;  3 885-890
    CrossrefPubMedGoogle Scholar
  • 26 Sanchez-Urdazpal L, Gores G J, Ward E M et al.. Diagnostic features and clinical outcome of ischemic-type biliary complications after liver transplantation.  Hepatology. 1993;  17 605-609
    PubMedGoogle Scholar
  • 27 Hisatsune H, Yazumi S, Egawa H et al.. Endoscopic management of biliary strictures after duct-to-duct biliary reconstruction in right-lobe living-donor liver transplantation.  Transplantation. 2003;  76 810-815
    PubMedGoogle Scholar
  • 28 Krom R A, Kingma L M, Haagsma E B, Wesenhagen H, Slooff M J, Gips C H. Choledochocholedochostomy, a relatively safe procedure in orthotopic liver transplantation.  Surgery. 1985;  97 552-556
    PubMedGoogle Scholar
  • 29 Soejima Y, Shimada M, Suehiro T et al.. Feasibility of duct-to-duct biliary reconstruction in left-lobe adult-living-donor liver transplantation.  Transplantation. 2003;  75 557-559
    PubMedGoogle Scholar
  • 30 Yanaga K, Sugimachi K. Biliary tract reconstruction in liver transplantation.  Surg Today. 1992;  22 493-500
    CrossrefPubMedGoogle Scholar
  • 31 Belli L, De Carlis L, Del Favero E et al.. Biliary complications in orthotopic liver transplantation: experience with a modified technique of duct-to-duct reconstruction.  Transpl Int. 1991;  4 161-165
    CrossrefPubMedGoogle Scholar
  • 32 Colonna II J O, Shaked A, Gomes A S et al.. Biliary strictures complicating liver transplantation. Incidence, pathogenesis, management, and outcome.  Ann Surg. 1992;  216 344-350
    PubMedGoogle Scholar
  • 33 Settmacher U, Steinmuller T H, Schmidt S C et al.. Technique of bile duct reconstruction and management of biliary complications in right lobe living donor liver transplantation.  Clin Transplant. 2003;  17 37-42
    CrossrefPubMedGoogle Scholar
  • 34 Northover J, Terblanche J. Bile duct blood supply. Its importance in human liver transplantation.  Transplantation. 1978;  26 67-69
    PubMedGoogle Scholar
  • 35 Northover J M, Terblanche J. A new look at the arterial supply of the bile duct in man and its surgical implications.  Br J Surg. 1979;  66 379-384
    Google Scholar
  • 36 Vellar I D. The blood supply of the biliary ductal system and its relevance to vasculobiliary injuries following cholecystectomy.  Aust N Z J Surg. 1999;  69 816-820
    PubMedGoogle Scholar
  • 37 Stapleton G N, Hickman R, Terblanche J. Blood supply of the right and left hepatic ducts.  Br J Surg. 1998;  85 202-207
    CrossrefPubMedGoogle Scholar
  • 38 Zajko A B, Campbell W L, Logsdon G A et al.. Cholangiographic findings in hepatic artery occlusion after liver transplantation.  AJR Am J Roentgenol. 1987;  149 485-489
    Google Scholar
  • 39 van Hoek B, Wiesner R H, Krom R A, Ludwig J, Moore S B. Severe ductopenic rejection following liver transplantation: incidence, time of onset, risk factors, treatment, and outcome.  Semin Liver Dis. 1992;  12 41-50
    Article in Thieme ConnectPubMedGoogle Scholar
  • 40 Campbell W L, Wiesner R H, Krom R A, Ludwig J, Moore S B. Intrahepatic biliary strictures after liver transplantation.  Radiology. 1994;  191 735-740
    PubMedGoogle Scholar
  • 41 Jeffrey G P, Brind A M, Ormonde D G et al.. Management of biliary tract complications following liver transplantation.  Aust N Z J Surg. 1999;  69 717-722
    PubMedGoogle Scholar
  • 42 Schlitt H J, Meier P N, Nashan B et al.. Reconstructive surgery for ischemic-type lesions at the bile duct bifurcation after liver transplantation.  Ann Surg. 1999;  229 137-145
    CrossrefPubMedGoogle Scholar
  • 43 Otto G, Roeren T, Golling M et al.. [Ischemic type lesions of the bile ducts after liver transplantation: 2 years results].  Zentralbl Chir. 1995;  120 450-454
    PubMedGoogle Scholar
  • 44 Oguma S, Belle S, Starzl T E, Demetris A J. A histometric analysis of chronically rejected human liver allografts: insights into the mechanisms of bile duct loss: direct immunologic and ischemic factors.  Hepatology. 1989;  9 204-209
    CrossrefPubMedGoogle Scholar
  • 45 Sanchez-Urdazpal L, Gores G J, Ward E M et al.. Ischemic-type biliary complications after orthotopic liver transplantation.  Hepatology. 1992;  16 49-53
    CrossrefPubMedGoogle Scholar
  • 46 Sheng R, Ramirez C B, Zajko A B, Campbell W L. Biliary stones and sludge in liver transplant patients: a 13-year experience.  Radiology. 1996;  198 243-247
    CrossrefPubMedGoogle Scholar
  • 47 Gugenheim J, Samuel D, Reynes M, Bismuth H. Liver transplantation across ABO blood group barriers.  Lancet. 1990;  336 519-523
    CrossrefPubMedGoogle Scholar
  • 48 Lo C M, Shaked A, Busuttil R W. Risk factors for liver transplantation across the ABO barrier.  Transplantation. 1994;  58 543-547
    PubMedGoogle Scholar
  • 49 Sanchez-Urdazpal L, Batts K P, Gores G J et al.. Increased bile duct complications in liver transplantation across the ABO barrier.  Ann Surg. 1993;  218 152-158
    PubMedGoogle Scholar
  • 50 Sung J Y, Costerton J W, Shaffer E A. Defense system in the biliary tract against bacterial infection.  Dig Dis Sci. 1992;  37 689-696
    CrossrefPubMedGoogle Scholar
  • 51 Ferraz-Neto B H, Mirza D F, Gunson B K et al.. Bile duct splintage in liver transplantation: is it necessary?.  Transpl Int. 1996;  9(suppl 1) S185-S187
    PubMedGoogle Scholar
  • 52 Mahajani R V, Cotler S J, Uzer M F. Efficacy of endoscopic management of anastomotic biliary strictures after hepatic transplantation.  Endoscopy. 2000;  32 943-949
    Article in Thieme ConnectPubMedGoogle Scholar
  • 53 Saab S, Martin P, Soliman G Y et al.. Endoscopic management of biliary leaks after T-tube removal in liver transplant recipients: nasobiliary drainage versus biliary stenting.  Liver Transpl. 2000;  6 627-632
    CrossrefPubMedGoogle Scholar
  • 54 Rolles K, Dawson K, Novell R, Hayter B, Davidson B, Burroughs A. Biliary anastomosis after liver transplantation does not benefit from T tube splintage.  Transplantation. 1994;  57 402-404
    PubMedGoogle Scholar
  • 55 Shah S R, Dooley J, Agarwal R et al.. Routine endoscopic retrograde cholangiography in the detection of early biliary complications after liver transplantation.  Liver Transpl. 2002;  8 491-494
    CrossrefPubMedGoogle Scholar
  • 56 Scatton O, Meunier B, Cherqui D et al.. Randomized trial of choledochocholedochostomy with or without a T tube in orthotopic liver transplantation.  Ann Surg. 2001;  233 432-437
    CrossrefPubMedGoogle Scholar
  • 57 Shimoda M, Saab S, Morrisey M et al.. A cost-effectiveness analysis of biliary anastomosis with or without T-tube after orthotopic liver transplantation.  Am J Transplant. 2001;  1 157-161
    PubMedGoogle Scholar
  • 58 O'Connor T P, Lewis W D, Jenkins R L. Biliary tract complications after liver transplantation.  Arch Surg. 1995;  130 312-317
    PubMedGoogle Scholar
  • 59 Rouch D A, Emond J C, Thistlethwaite Jr J R, Mayes J T, Broelsch C E. Choledochocholedochostomy without a T tube or internal stent in transplantation of the liver.  Surg Gynecol Obstet. 1990;  170 239-244
    PubMedGoogle Scholar
  • 60 Icoz G, Kilic M, Zeytunlu M et al.. Biliary reconstructions and complications encountered in 50 consecutive right-lobe living donor liver transplantations.  Liver Transpl. 2003;  9 575-580
    CrossrefPubMedGoogle Scholar
  • 61 Kawachi S, Shimazu M, Wakabayashi G et al.. Biliary complications in adult living donor liver transplantation with duct-to-duct hepaticocholedochostomy or Roux-en-Y hepaticojejunostomy biliary reconstruction.  Surgery. 2002;  132 48-56
    CrossrefPubMedGoogle Scholar
  • 62 Fan S T, Lo C M, Liu C L, Tso W K, Wong J. Biliary reconstruction and complications of right lobe live donor liver transplantation.  Ann Surg. 2002;  236 676-683
    CrossrefPubMedGoogle Scholar
  • 63 Ishiko T, Egawa H, Kasahara M et al.. Duct-to-duct biliary reconstruction in living donor liver transplantation utilizing right lobe graft.  Ann Surg. 2002;  236 235-240
    CrossrefPubMedGoogle Scholar
  • 64 Fondevila C, Ghobrial R M, Fuster J, Bombuy E, Garcia-Valdecasas J C, Busuttil R W. Biliary complications after adult living donor liver transplantation.  Transplant Proc. 2003;  35 1902-1903
    CrossrefPubMedGoogle Scholar
  • 65 Fulcher A S, Turner M A, Ham J M. Late biliary complications in right lobe living donor transplantation recipients: imaging findings and therapeutic interventions.  J Comput Assist Tomogr. 2002;  26 422-427
    CrossrefPubMedGoogle Scholar
  • 66 Grewal H P, Thistlewaite Jr J R, Loss G E et al.. Complications in 100 living-liver donors.  Ann Surg. 1998;  228 214-219
    CrossrefPubMedGoogle Scholar
  • 67 Kadmon M, Bleyl J, Kuppers B, Otto G, Herfarth C. Biliary complications after prolonged University of Wisconsin preservation of liver allografts.  Transplant Proc. 1993;  25 1651-1652
    PubMedGoogle Scholar
  • 68 McDonald V, Matalon T A, Patel S K et al.. Biliary strictures in hepatic transplantation.  J Vasc Interv Radiol. 1991;  2 533-538
    CrossrefPubMedGoogle Scholar
  • 69 Scotte M, Dousset B, Calmus Y, Conti F, Houssin D, Chapuis Y. The influence of cold ischemia time on biliary complications following liver transplantation.  J Hepatol. 1994;  21 340-346
    CrossrefPubMedGoogle Scholar
  • 70 Belzer F O, D’Alessandro A, Hoffmann R, Kalayoglu M, Sollinger H. Management of the common duct in extended preservation of the liver.  Transplantation. 1992;  53 1166-1167
    PubMedGoogle Scholar
  • 71 Noack K B, Osmon D R, Batts K P, Wilhelm M, Krom R A, Lindor K D. Successful orthotopic liver transplantation in a patient with refractory biliary candidiasis.  Gastroenterology. 1991;  101 1728-1730
    PubMedGoogle Scholar
  • 72 Paya C V, Hermans P E, Washington II J A et al.. Incidence, distribution, and outcome of episodes of infection in 100 orthotopic liver transplantations.  Mayo Clin Proc. 1989;  64 555-564
    PubMedGoogle Scholar
  • 73 Ward E M, Kiely M J, Maus T P, Wiesner R H, Krom R A. Hilar biliary strictures after liver transplantation: cholangiography and percutaneous treatment.  Radiology. 1990;  177 259-263
    PubMedGoogle Scholar
  • 74 Bourgeois N, Deviere J, Yeaton P et al.. Diagnostic and therapeutic endoscopic retrograde cholangiography after liver transplantation.  Gastrointest Endosc. 1995;  42 527-534
    CrossrefPubMedGoogle Scholar
  • 75 Verran D J, Asfar S K, Ghent C N, Grant D R, Wall W J. Biliary reconstruction without T tubes or stents in liver transplantation: report of 502 consecutive cases.  Liver Transpl Surg. 1997;  3 365-373
    PubMedGoogle Scholar
  • 76 Ludwig J, Batts K P, MacCarty R L. Ischemic cholangitis in hepatic allografts.  Mayo Clin Proc. 1992;  67 519-526
    PubMedGoogle Scholar
  • 77 Laghi A, Pavone P, Catalano C et al.. MR cholangiography of late biliary complications after liver transplantation.  AJR Am J Roentgenol. 1999;  172 1541-1546
    PubMedGoogle Scholar
  • 78 Meersschaut V, Mortele K J, Troisi R et al.. Value of MR cholangiography in the evaluation of postoperative biliary complications following orthotopic liver transplantation.  Eur Radiol. 2000;  10 1576-1581
    CrossrefPubMedGoogle Scholar
  • 79 Kurzawinski T R, Selves L, Farouk M et al.. Prospective study of hepatobiliary scintigraphy and endoscopic cholangiography for the detection of early biliary complications after orthotopic liver transplantation.  Br J Surg. 1997;  84 620-623
    Google Scholar
  • 80 Barton P, Maier A, Steininger R, Muhlbacher F, Lechner G. Biliary sludge after liver transplantation: 1. Imaging findings and efficacy of various imaging procedures.  AJR Am J Roentgenol. 1995;  164 859-864
    PubMedGoogle Scholar
  • 81 Van Hoek B, Kool L J, Ringers J, Terpstra O T. Long-term treatment of recurrent perihilar nonanastomotic biliary strictures after liver transplantation with expandable metallic stents.  Transplantation. 1995;  60 399-401
    PubMedGoogle Scholar
  • 82 Wozney P, Zajko A B, Bron K M, Point S, Starzl T E. Vascular complications after liver transplantation: a 5-year experience.  AJR Am J Roentgenol. 1986;  147 657-663
    PubMedGoogle Scholar
  • 83 Osorio R W, Freise C E, Stock P G et al.. Nonoperative management of biliary leaks after orthotopic liver transplantation.  Transplantation. 1993;  55 1074-1077
    CrossrefPubMedGoogle Scholar
  • 84 Donovan J. Nonsurgical management of biliary tract disease after liver transplantation.  Gastroenterol Clin North Am. 1993;  22 317-336
    PubMedGoogle Scholar
  • 85 Zajko A B, Campbell W L, Bron K M et al.. Cholangiography and interventional biliary radiology in adult liver transplantation.  AJR Am J Roentgenol. 1985;  144 127-133
    PubMedGoogle Scholar
  • 86 Sheng R, Sammon J K, Zajko A B, Campbell W L. Bile leak after hepatic transplantation: cholangiographic features, prevalence, and clinical outcome.  Radiology. 1994;  192 413-416
    CrossrefPubMedGoogle Scholar
  • 87 Pfau P R, Kochman M L, Lewis J D et al.. Endoscopic management of postoperative biliary complications in orthotopic liver transplantation.  Gastrointest Endosc. 2000;  52 55-63
    CrossrefPubMedGoogle Scholar
  • 88 Roumilhac D, Poyet G, Sergent G et al.. Long-term results of percutaneous management for anastomotic biliary stricture after orthotopic liver transplantation.  Liver Transpl. 2003;  9 394-400
    CrossrefPubMedGoogle Scholar
  • 89 Mosca S, Militerno G, Guardascione M A, Amitrano L, Picciotto F P, Cuomo O. Late biliary tract complications after orthotopic liver transplantation: diagnostic and therapeutic role of endoscopic retrograde cholangiopancreatography.  J Gastroenterol Hepatol. 2000;  15 654-660
    CrossrefPubMedGoogle Scholar
  • 90 Testa G, Malago M, Valentin-Gamazo C, Lindell G, Broelsch C E. Biliary anastomosis in living related liver transplantation using the right liver lobe: techniques and complications.  Liver Transpl. 2000;  6 710-714
    CrossrefPubMedGoogle Scholar
  • 91 Sherman S, Jamidar P, Shaked A, Kendall B J, Goldstein L I, Busuttil R W. Biliary tract complications after orthotopic liver transplantation: endoscopic approach to diagnosis and therapy.  Transplantation. 1995;  60 467-470
    PubMedGoogle Scholar
  • 92 Rossi A F, Grosso C, Zanasi G et al.. Long-term efficacy of endoscopic stenting in patients with stricture of the biliary anastomosis after orthotopic liver transplantation.  Endoscopy. 1998;  30 360-366
    PubMedGoogle Scholar
  • 93 Rieber A, Brambs H J, Lauchart W. The radiological management of biliary complications following liver transplantation.  Cardiovasc Intervent Radiol. 1996;  19 242-247
    CrossrefPubMedGoogle Scholar
  • 94 Rizk R S, McVicar J P, Emond M J et al.. Endoscopic management of biliary strictures in liver transplant recipients: effect on patient and graft survival.  Gastrointest Endosc. 1998;  47 128-135
    CrossrefPubMedGoogle Scholar
  • 95 Schwartz D A, Petersen B T, Poterucha J J, Gostout C J. Endoscopic therapy of anastomotic bile duct strictures occurring after liver transplantation.  Gastrointest Endosc. 2000;  51 169-174
    CrossrefPubMedGoogle Scholar
  • 96 Bouttier E, Arrive L, Rotenberg L et al.. [Non-surgical treatment of biliary stenoses after hepatic transplantation].  J Radiol. 1997;  78 485-489
    PubMedGoogle Scholar
  • 97 Sung R S, Campbell Jr D A, Rudich S M et al.. Long-term follow-up of percutaneous transhepatic balloon cholangioplasty in the management of biliary strictures after liver transplantation.  Transplantation. 2004;  77 110-115
    PubMedGoogle Scholar
  • 98 Zajko A B, Bron K M, Campbell W L, Behal R, Van Thiel D H, Starzl T E. Percutaneous transhepatic cholangiography and biliary drainage after liver transplantation: a five-year experience.  Gastrointest Radiol. 1987;  12 137-143
    CrossrefPubMedGoogle Scholar
  • 99 Davidson B R, Rai R, Nandy A, Doctor N, Burroughs A, Rolles K. Results of choledochojejunostomy in the treatment of biliary complications after liver transplantation in the era of nonsurgical therapies.  Liver Transpl. 2000;  6 201-206
    PubMedGoogle Scholar
  • 100 Diamond N G, Lee S P, Niblett R L, Rees C R, Klintmalm G B. Metallic stents for the treatment of intrahepatic biliary strictures after liver transplantation.  J Vasc Interv Radiol. 1995;  6 755-761
    PubMedGoogle Scholar
  • 101 Culp W C, McCowan T C, Lieberman R P, Goertzen T C, LeVeen R F, Heffron T G. Biliary strictures in liver transplant recipients: treatment with metal stents.  Radiology. 1996;  199 339-346
    PubMedGoogle Scholar
  • 102 Waldram R, Williams R, Calne R Y. Bile composition and bile cast formation after transplantation of the liver in man.  Transplantation. 1975;  19 382-387
    PubMedGoogle Scholar
  • 103 Starzl T E, Putnam C W, Hansbrough J F, Porter K A, Reid H A. Biliary complications after liver transplantation: with special reference to the biliary cast syndrome and techniques of secondary duct repair.  Surgery. 1977;  81 212-221
    PubMedGoogle Scholar
  • 104 Farouk M, Branum G D, Watters C R et al.. Bile compositional changes and cholesterol stone formation following orthotopic liver transplantation.  Transplantation. 1991;  52 727-730
    PubMedGoogle Scholar
  • 105 Le Thai B, Dumont M, Michel A, Erlinger S, Houssin D. Cholestatic effect of cyclosporine in the rat: an inhibition of bile acid secretion.  Transplantation. 1988;  46 510-512
    PubMedGoogle Scholar
  • 106 Barton P, Steininger R, Maier A, Muhlbacher F, Lechner G. Biliary sludge after liver transplantation: 2. Treatment with interventional techniques versus surgery and/or oral chemolysis.  AJR Am J Roentgenol. 1995;  164 865-869
    PubMedGoogle Scholar
  • 107 Campbell W L, Foster R G, Miller W J, Lecky J W, Zajko A B, Lee K Y. Changes in extrahepatic bile duct caliber in liver transplant recipients without evidence of biliary obstruction.  AJR Am J Roentgenol. 1992;  158 997-1000
    PubMedGoogle Scholar
  • 108 Douzdjian V, Abecassis M M, Johlin F C. Sphincter of Oddi dysfunction following liver transplantation: screening by bedside manometry and definitive manometric evaluation.  Dig Dis Sci. 1994;  39 253-256
    PubMedGoogle Scholar
  • 109 Abcarian P W, Emond J C, Ring E J. Cystic duct remnant mucocele in a liver transplant recipient.  J Vasc Interv Radiol. 1994;  5 127-130
    CrossrefPubMedGoogle Scholar

Nishita KotharyM.D. 

Assistant Professor of Radiology, Division of Vascular and Interventional Radiology, Columbia University Medical Center

Columbia University Medical Center, 177 Fort Washington Avenue

MHB-4HN 4-100, New York, NY 10032