Management of biliary complications following orthotopic liver transplantation
Andrew E Scanga1, Kris V Kowdley
1Division of Gastroenterology, Department of Medicine, University of Washington Medical Center, Box 356174, 1959 NE Pacific Street, Seattle, WA 98195-6174, USA.
Abstract:
Biliary complications are a major cause of morbidity following orthotopic liver transplantation with an overall incidence between 11% and 25%. The most common complications are biliary leaks, strictures, and stones. These complications have an impact on graft survival, length of hospital stay, recovery, and overall cost of care. Therefore, knowledge of these complications and their management is important to the practicing gastroenterologist. Historically, biliary complications after liver transplantation have been managed surgically. However, with the growth of therapeutic endoscopic and percutaneous radiologic methods, most of these complications can now be managed less invasively. This article focuses on the incidence, timing, mechanism, and endoscopic management of biliary leak, strictures, stones, sludge, casts, and sphincter of Oddi dysfunction following liver transplantation.
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