Biliary tract problems frequently complicate liver transplantation, and Sir Roy Calne's
often quoted comment that biliary reconstruction is the “technical Achilles' heel”
1
of transplantation remains applicable. The incidence of biliary tract complications
varies by center, but in recent series it ranges from 16% to 19%.
2
,
3
,
4
Early complications (less than 30 days after transplantation) include bile leaks,
sphincter dysfunction, and extrinsic obstruction. Late complications include anastomotic
and intrahepatic strictures, as well as T-tube complications which can present early
or late.To read this article in full you will need to make a payment
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References
- A new technique for biliary drainage in orthotopic liver transplantation utilizing the gallbladder as a pedicle graft conduit between the donor and recipient common bile ducts.Ann Surg. 1976; 184: 605-609
- Diagnosis and treatment of biliary complications after orthotopic liver transplantation.Surgery. 1989; 106: 675-684
- Analysis of surgical complications after 397 hepatic transplantations.Surg Gynecol Obstet. 1990; 170: 317-322
- Biliary tract complications after orthotopic liver transplantation.Transplant Proc. 1991; 23: 1956
- Non-surgical management of biliary tract diseases after liver transplantation.Gastroenterol Clin North Am. 1993; 22: 317-336
- Endoscopic retrograde cholangiopancreatography (ERCP).in: 3rd ed. Practical gastrointestinal endoscopy. Blackwell Scientific, London1990: 85-117
- Therapeutic endoscopic retrograde cholangio-pancreatography (ERCP).in: Practical gastrointestinal endoscopy. 3rd ed. Blackwell Scientific, London1990: 118-159
- Incidence and risk factors for biliary and pancreatic stent migration.Gastrointest Endosc. 1992; 38: 341-346
- Pancreatitis and duodenal perforation as complications of an endoscopically placed biliary stent.Gastrointest Endosc. 1994; 40: 365-366
- Biliary stent migration with colonic diverticular impaction.Gastrointest Endosc. 1992; 38: 81-83
Article info
Footnotes
☆From the Department of Medicine, the University of British Columbia and the British Columbia Transplant Society, Vancouver, British Columbia, Canada.
☆☆Reprint requests: Eric M. Yoshida MD, FRCPC, The British Columbia Transplant Society, East Tower, 4th Floor, 555 West 12th Ave., Vancouver, BC, V5Z 3X7, Canada.
★37/54/88354
Identification
Copyright
© 1998 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.
