Section 11. Radiological intervention approaches to biliary complications after living donor liver transplantation

Although endoscopic treatment has become the first choice to treat biliary complications, percutaneous transhepatic treatment still has important roles to treat biliary stricture or leak after living donor liver transplantation. This study reviewed a total of 527 recipients who had undergone percutaneous transhepatic treatment to treat biliary stricture (n=498) and leaks (n=29). Percutaneous transhepatic treatment included percutaneous transhepatic biliary drainage, perihepatic biloma drainage, balloon dilation of biliary stricture, and drainage catheter interposition or retrievable covered stent placement across a stricture or leak segment. Clinical success was achieved in 440 (88.4%) recipients with biliary stricture and 19 (65.5%) recipients with bile leaks. Percutaneous transhepatic treatment seems to be an effective alternative for treating biliary complications resistant to or inaccessible by endoscopic treatment.