15 December 2015 : Original article
Endoscopic Treatment of Early Biliary Complications in Liver Transplant Recipients
Konrad KobryńABCDEF, Sławomir KoziełBD, Marta PoręckaBC, Krzysztof KobryńBC, Wacław HołówkoBD, Waldemar PatkowskiDF, Krzysztof ZieniewiczDF, Tadeusz WróblewskiAEF, Marek KrawczykDEFDOI: 10.12659/AOT.896786
Ann Transplant 2015; 20:741-746
Abstract
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
In Press
Original article
Simultaneous Liver and Kidney Transplant in a Middle-Income Country: A Single-Center ExperienceAnn Transplant In Press; DOI: 10.12659/AOT.947649
Original article
Outcomes of Combined Liver-Kidney Transplantation in Polycystic Liver and Kidney DiseaseAnn Transplant In Press; DOI: 10.12659/AOT.947639
Most Viewed Current Articles
03 Jan 2023 : Original article 6,872
Impact of Autologous Stem Cell Transplantation on Primary Central Nervous System Lymphoma in First-Line and...DOI :10.12659/AOT.938467
Ann Transplant 2023; 28:e938467
15 Aug 2023 : Review article 6,817
Free-Circulating Nucleic Acids as Biomarkers in Patients After Solid Organ TransplantationDOI :10.12659/AOT.939750
Ann Transplant 2023; 28:e939750
16 May 2023 : Original article 6,561
Breaking Antimicrobial Resistance: High-Dose Amoxicillin with Clavulanic Acid for Urinary Tract Infections ...DOI :10.12659/AOT.939258
Ann Transplant 2023; 28:e939258
28 May 2024 : Original article 5,900
Effect of Dexmedetomidine Combined with Remifentanil on Emergence Agitation During Awakening from Sevoflura...DOI :10.12659/AOT.943281
Ann Transplant 2024; 29:e943281