Endoscopy 2019; 51(04): S235
DOI: 10.1055/s-0039-1681874
ESGE Days 2019 ePosters
Friday, April 5, 2019 09:00 – 17:00: ERCP ePosters
Georg Thieme Verlag KG Stuttgart · New York

ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY IN THE MANAGEMENT OF BILIARY COMPLICATIONS AFTER ORTHOTOPIC LIVER TRANSPLANTATION

J Egea Valenzuela
1   Digestive Diseases – Digestive Endoscopy, H. Virgen de la Arrixaca, Murcia, Spain
,
R Jijon Crespin
1   Digestive Diseases – Digestive Endoscopy, H. Virgen de la Arrixaca, Murcia, Spain
,
A Serrano Jimenez
1   Digestive Diseases – Digestive Endoscopy, H. Virgen de la Arrixaca, Murcia, Spain
,
F Alberca de las Parras
1   Digestive Diseases – Digestive Endoscopy, H. Virgen de la Arrixaca, Murcia, Spain
› Author Affiliations
Further Information

Publication History

Publication Date:
18 March 2019 (online)

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Aims:

Biliary complications are frequent after orthotopic liver transplantation. Management of these complications with endoscopic retrograde cholangiopancreatography (ERCP) is available. The aim of the present study was to analyze the experience in the endoscopic management of biliary complications after liver transplantation in a third level center, and to determinate the factors associated with higher rates of technical and clinical success.

Methods:

Observational retrospective study including ERCPs performed in patients with biliary complications after liver transplantation between February 2012 and January 2017. Factors analyzed were: demographics, time between transplantation and ERCP, indications for ERCP, strategy of stenting (only plastic stents, only self-expandable metallic stents, plastic followed by metallic stents, and metallic followed by plastic stents), technical and clinical success, and complications.

Results:

One hundred and sixty-eight endoscopies were performed in 58 patients. Thirty-three patients (56,9%) presented with early complications. The most frequent indication for ERCP was anastomotic stenosis (57,8%). Technical success in the first ERCP was achieved in 43 patients (74,1%). Early onset of the biliary complications was associated with higher rates of technical success (OR: 6,49; p: 0,036). Clinical success was obtained in 36 cases (62,1%). Patients with early complications presented higher probability of having good clinical response (OR: 11,16; p: 0,033). Results were worse in patients receiving only plastic stents (50% of clinical success). Eleven complications were observed among 168 ERCPs (6,54%), including 2 pancreatitis, 5 bleeding events, 3 cholangitis and 1 micro-perforation.

Conclusions:

ERCP is safe and useful in the management of biliary complications after liver transplantation. Early onset of the complications is associated with better results. Some patients will need repeated procedures to obtain a good clinical response.