[Biliary complications after liver transplantation]

Biliary complications after liver transplantation are common and to a great degree define the outcome of the operation. In connection with the frequently observed postoperative complications on this level, Calne RY considers the biliary anastomosis as the "Achilles heel" of the operative intervention. Biliary leaks and strictures in the early postoperative period are a result of technical causes. Late complications have a complex character and mostly occur after occlusion of the hepatic artery, preservation injury, transplant rejection, recurrence of the primary decease and initiation de novo malignant disease. The early diagnosis of the biliary complications is based on the precise observation of the patient's clinical status, of the laboratory levels and of the control ultraconography and cholangiography. The treatment of the biliary complications, diagnosed intraoperatively, is immediate. The early postoperative complications, depending on the type of the performed biliary anastomosis, are mainly treated with nonsurgical methods--endoscopic dilation and stabilizing stent. Late complications, most frequently intrahepatic strictures, require surgical intervention.