Post-liver transplant biliary complications: Current knowledge and therapeutic advances

Area of Science:

• Hepatology
• Gastroenterology
• Transplant Surgery

Background:

• Liver transplantation is a standard treatment for end-stage liver disease, acute liver failure, and liver tumors.
• Despite surgical and immunosuppressive advances, high postoperative morbidity and mortality persist, largely due to biliary complications.
• Biliary complications, such as strictures and leaks, affect up to 25% of liver transplant recipients.

Purpose of the Study:

• To review common post-transplant biliary complications.
• To discuss available interventional treatment modalities for these complications.
• To highlight the increasing role of endoscopic techniques in managing biliary issues.

Main Methods:

• Review of common biliary complications post-liver transplantation.
• Discussion of surgical, percutaneous, and endoscopic treatment options.
• Emphasis on endoscopic retrograde cholangiography and newer endoscopic techniques.

Main Results:

• Biliary complications are a leading cause of morbidity and mortality after liver transplantation.
• Endoscopic techniques, particularly endoscopic retrograde cholangiography, are increasingly replacing surgical and percutaneous approaches.
• Newer endoscopic devices and techniques have improved the success rates of minimally invasive procedures.

Conclusions:

• Early recognition and aggressive endoscopic therapy are crucial for reducing morbidity and mortality from post-transplant biliary complications.
• Endoscopic management is becoming the preferred approach for many biliary complications.
• Understanding complication mechanisms aids in timely and effective treatment.