Biliary complications after living donor liver transplantation: endoscopic diagnosis and management of 28 cases / 中华消化内镜杂志

ABSTRACT

ObjectiveTo retrospectively investigate the clinical features of the biliary tract complieations after living donor liver transplantation (LDLT) and the efficacy of endoscopy.MethodsThe LDLT patients with hiliary eomplieations were given endoscopic retrograde eholangiopanereatography (ERCP) and endoscopic therapies were carried out according to the result of eholangiogram.ResultsTwenty-one patients,among whom 43.8% were at early postoperative stage,underwent 28 endoscopic procedures.Nineteen patients (90.4%) had biliary anastomotic strictures with angled malformation.Bile leakage was found in 9 patients (42.9%).The success rate of endoscopic therapy was 85.7% ,including nose-bile drainage in 5,stent placement in 10,balloon dilatation and/or multiple stents placement in 9 and bile collection drainage in 2.During follow-up,leak heal was confirmed in 3 patients and stricture resolution was achieved in another 2 eases. ConclusionBiliary complication is relatively common in the early stage after LDIX,and severe anastomotie stricture with angled malformation is most frequently seen, usually associated with bile leakage. Series of endoscopic interventions with the strategy of "leak first,and then stricture"might achieve satisfactory outcome.