Digital single-operator cholangioscopy in the evaluation of biliary strictures after liver transplantation

Biliary tract complications after orthotopic liver transplantation (OLT) are frequently reported. The diagnosis and management of these complications have become increasingly crucial, with digital single operator cholangioscopy (DSOC) emerging as an essential tool. We describe the approach to biliary complications using DSOC in 5 patients post-OLT. Inflammatory and ischemic stricture, a stricture secondary to post-transplant lymphoproliferative disease, and common bile duct lithiasis were the main findings. The exceptional image quality provided by the DSCO allowed us to precisely characterize strictures, observe epithelial changes, and identify obstructions due to bile casts that remained undetectable through ERCP. DSOC is a viable method for evaluating post-OLT biliary complications, offering alternative therapies beyond ERCP, thus improving care precision and outcomes.