[Multifocal biliary papillomatosis: an indication for liver transplantation]

Area of Science:

• Gastroenterology and Hepatology
• Surgical Oncology

Background:

• Biliary papillomatosis is an uncommon biliary tract disease.
• High recurrence rates and malignant transformation potential necessitate aggressive treatment.
• Orthotopic liver transplantation is a potential curative option.

Observation:

• A 60-year-old patient presented with diffuse bilobar biliary papillomatosis.
• Complications included cholangitis, cholestasis, portal hypertension (esophageal varices, hypersplenism), and hydroelectrolytic imbalance from external biliary drainage.
• Endoscopic retrograde cholangiopancreatography (ERCP) with biopsies confirmed the diagnosis.

Findings:

• The patient underwent successful orthotopic liver transplantation.
• Postoperative recovery was uncomplicated.
• At 9 months post-transplant, the patient was asymptomatic with a satisfactory clinical evolution.

Implications:

• Liver transplantation offers a viable treatment for complex biliary papillomatosis.
• This case highlights the successful management of a rare condition with significant complications.
• Further research into alternative and adjunctive therapies is warranted.