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Updated: Oct 23, 2025
Endoscopic Ultrasound-Guided Biliary Drainage: Endoscopic Ultrasound-Guided Hepaticogastrostomy in Malignant Biliary Obstruction
Published on: March 25, 2022
Delayed Expulsion of biliary cast after hepaticojejunostomy for post-liver transplantation biliary stricture-better
Sathish Kumar Krishnan1, Joy Varghese2, Rajanikanth Patcha1
1Department of HPB & Liver Transplantation, Institute of Liver Disease & Transplantation, Gleneagles Global Health City, Chennai, India.
Background:
Biliary strictures after living donor liver transplantation (LDLT) are a significant cause of post-transplant morbidity. Endoscopic therapy is usually the first choice of treatment though surgical treatment may provide better biliary drainage.
Methods:
We report a case of LDLT performed in a child for acute liver failure who developed an anastomotic biliary stricture with biliary cast formation. We performed a Roux en Y hepaticojejunostomy to treat the stricture.
Results:
Allograft function improved after surgery with no further episodes of cholangitis. Two months after the surgery, the child passed a large biliary cast in the stools. This reiterates the advantage of wide biliary drainage provided through surgical therapy.
Conclusions:
Surgery for biliary strictures following LDLT may provide superior long term biliary drainage- especially when biliary casts are present.
