Bile leakage as a complication of liver biopsy in liver transplants

Four liver transplant recipients with intrahepatic bile duct leakage following liver biopsy are described. Two patients were clinically suspected of having a bile leak, one of whom had bile peritonitis. All four patients had elevated liver enzyme levels. In three patients, cholangiography showed contrast media leakage into the peritoneum through the needle biopsy tract; one leak was totally intraparenchymal. All patients had varying degrees of biliary obstruction. The differential diagnosis of bile leakage post-transplantation should include recent liver biopsy.