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Digestive Disease Interventions 2019; 03(04): 295-304
DOI: 10.1055/s-0039-3400493
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Endoscopic Management of Biliary Complications after Liver Transplant

Ali Akram
1   Division of Gastroenterology, Department of Medicine, University of California San Diego Health Sciences, San Diego, California
,
Robert Klapheke
1   Division of Gastroenterology, Department of Medicine, University of California San Diego Health Sciences, San Diego, California
,
Wilson Kwong
1   Division of Gastroenterology, Department of Medicine, University of California San Diego Health Sciences, San Diego, California
› Author Affiliations
Further Information

Publication History

28 February 2019

15 October 2019

Publication Date:
27 November 2019 (online)

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Abstract

Orthotropic liver transplant (OLT) is the definitive treatment for patients with end stage liver disease of all etiologies. Biliary complications are common after OLT and living donor liver transplant (LDLT). Approximately, 15% of patients undergoing deceased donor liver transplant develop strictures and this number is even higher in LDLT recipients (28–32%).[1] [2] Common biliary complications include anastomotic and non-anastomotic strictures, bile leaks, biliary casts, and stones.[3] Endoscopic therapy has become the mainstay of management of these biliary conditions. Endoscopic therapy involves sphincterotomy, dilation, and stent deployment to maintain patency of the bile duct and provide adequate drainage. This article will review current literature regarding endoscopic management of biliary complications after liver transplant and discuss recent endoscopic advances that can reduce the need for reoperation.

Keywords

ERCP - liver transplant - biliary stricture - bile leak - biliary cast syndrome

Disclosures

None.


 

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