ISSN 1300-4948 | E-ISSN 2148-5607
Original Article
Endoscopic treatment of biliary complications following liver transplantation
1 Department of Gastroenterology, Ankara University Faculty of Medicine, Ankara, Turkey  
2 Department of Surgery, Ankara University Faculty of Medicine, Ankara, Turkey  
3 Ankara Üniversitesi Tıp Fakültesi Gastroenteroloji Bilim Dalı, Ankara  
Turk J Gastroenterol 2014; 25: 156-161
DOI: 10.5152/tjg.2014.4055
Key Words: Biliary complications, liver transplantation, biliary stricture, therapeutic endoscopy
Abstract

Background/Aims: The aims of the present study were to review biliary complications following liver transplantation in a single-center experience, to identify the factors associated with biliary complications, and to evaluate the success of endoscopic and percutaneous treatment in such patients.

 

Materials and Methods: Between January 1994 and June 2010, a total of 176 patients with liver disease underwent liver transplantation; 119 recipients were included in this retrospective analysis. Median posttransplant follow-up period was 49 months.

 

Results: Mean age was 43.0±12.7 years. Living donor liver transplantation (LDLT) and deceased-donor liver transplantation (DDLT) were performed in 71 and 48 patients, respectively. Duct-to-duct anastomosis and Roux-en-Y hepaticojejunostomy were performed in 68 and 51 patients, respectively.

The overall incidence of posttransplant biliary complications was 36%; anastomotic biliary strictures were the most common biliary complications (42%), followed by biliary leakage (28%). On logistic regression analysis, duct-duct anastomosis was the only risk factor associated with the development of biliary complications (Odds ratio (OR), 3.346; p=0.005). Endoscopic and percutaneous treatment was successful in the majority of patients (81%), and the remaining 19% recipients underwent surgery for biliary repair. Endoscopic retrograde cholangiopancreatography (ERCP) guided drainage and balloon dilatation with stent placement were the most common treatment modalities.

 

 

Conclusion: Biliary complications were most frequent after liver transplantation; biliary strictures were the most commonly seen. The use of duct-to-duct anastomosis for biliary reconstruction is a risk factor for the development of biliary complications. Endoscopic and percutaneous treatment was successful in the majority of these patients.

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