Endoscopic Management of Biliary Issues in the Liver Transplant Patient

James F Crismale; Jawad Ahmad

doi:10.1016/j.giec.2018.11.003

Endoscopic Management of Biliary Issues in the Liver Transplant Patient

Gastrointest Endosc Clin N Am. 2019 Apr;29(2):237-256. doi: 10.1016/j.giec.2018.11.003. Epub 2019 Feb 2.

Authors

James F Crismale¹, Jawad Ahmad²

Affiliations

¹ Recanati/Miller Transplantation Institute, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029, USA.
² Recanati/Miller Transplantation Institute, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029, USA. Electronic address: jawad.ahmad@mountsinai.org.

PMID: 30846151
DOI: 10.1016/j.giec.2018.11.003

Abstract

Biliary complications remain a common problem after liver transplantation (LT). The therapeutic endoscopist encounters a variety of situations in LT including strictures at the duct-to-duct biliary anastomosis, strictures elsewhere in the biliary tree caused by an ischemic injury, and bile leaks at the anastomosis or from the cut surface and stone disease. Biliary complications lead to significant morbidity and occasionally reduced graft and patient survival. Several factors increase the risk of strictures and leaks. Endoscopic intervention in experienced hands is successful in the management of biliary complications following LT and percutaneous or surgical correction should seldom be required.

Keywords: Bile leak; Biliary stricture; ERCP; Liver transplantation.

Publication types

Review

MeSH terms

Anastomosis, Surgical / adverse effects
Anastomotic Leak / etiology
Anastomotic Leak / therapy*
Bile Ducts / pathology
Bile Ducts / surgery*
Cholangiopancreatography, Endoscopic Retrograde*
Cholestasis / etiology
Cholestasis / therapy*
Gallstones / etiology
Gallstones / therapy
Humans
Liver Transplantation / adverse effects*
Living Donors
Stents