Year 2020 / Volume 112 / Number 8
Original
Endoscopic treatment of biliary complications after liver transplantation

605-608

DOI: 10.17235/reed.2020.6704/2019

María López Álvarez, Alejandra Otero, Maria Angeles Vázquez Millán, Francisco Suárez López, Pedro Alonso Aguirre,

Abstract
Background: biliary complications are an important cause of morbidity and mortality after liver transplantation. Endoscopic retrograde cholangiopancreatography (ERCP) is a therapeutic option, which is less invasive than surgical management. Materials and methods: the endoscopic management with ERCP of patients with biliary complications after liver transplantation in the Complexo Hospitalario Universitario de A Coruña between 2012 and 2018 was reviewed. Results: there were 232 liver transplant recipients and biliary complications occurred in 70 (30.1 %) patients. Anastomotic strictures, most of them choledocho-choledochal, constituted the most frequent complication in 43 (61.4 %) patients. Biliary leak occurred in 16 (22.9 %) patients, non-anastomotic strictures in six (8.6 %) and choledocholithiasis in five (7.1 %). ERCP was performed in 39/43 patients with anastomotic strictures, achieving clinical success in 36 (92.3 %). All patients with a biliary leak were treated with CPRE, with a clinical resolution in 10/16 (62.5 %). ERCP was successful in 3/5 patients (60 %) with bile duct stones. In non-anastomotic strictures, ERCP was not effective in any case. Regarding complications, five (7.7 %) patients presented mild-moderate bleeding after biliary sphincterotomy. Conclusion: in our study, ERCP is useful in most biliary anastomotic strictures, early biliary leaks and choledocholithiasis after liver transplantation. The rate of ERCP complications in these patients was low and none were lethal.
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López Álvarez M, Otero A, Vázquez Millán M, Suárez López F, Alonso Aguirre P. Endoscopic treatment of biliary complications after liver transplantation. 6704/2019


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Publication history

Received: 25/10/2019

Accepted: 30/12/2019

Online First: 16/06/2020

Published: 30/07/2020

Article revision time: 63 days

Article Online First time: 235 days

Article editing time: 279 days


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