Advertisement

Abdominal pain and rectal bleeding as a complication of biliary stent migration in a liver transplant recipient

      Biliary tract problems frequently complicate liver transplantation, and Sir Roy Calne's often quoted comment that biliary reconstruction is the “technical Achilles' heel”
      • Calne RY.
      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.
      of transplantation remains applicable. The incidence of biliary tract complications varies by center, but in recent series it ranges from 16% to 19%.
      • Stratta RJ
      • Wood P
      • Lanagnas AN
      • Hollins RR
      • Bruder LK.
      • Donovan JP
      • et al.
      Diagnosis and treatment of biliary complications after orthotopic liver transplantation.
      • Lebeau G
      • Yanaga K
      • Marsh JW
      • Tzakis AG
      • Makowka L
      • Gordon RD
      • et al.
      Analysis of surgical complications after 397 hepatic transplantations.
      • D'Alessandro AM
      • Kalayoglu M
      • Pirsh JD
      • Sollinger HW
      • Reed A
      • Knechtle SJ.
      Biliary tract complications after orthotopic liver transplantation.
      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

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Gastrointestinal Endoscopy
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Calne RY.
        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
        • Stratta RJ
        • Wood P
        • Lanagnas AN
        • Hollins RR
        • Bruder LK.
        • Donovan JP
        • et al.
        Diagnosis and treatment of biliary complications after orthotopic liver transplantation.
        Surgery. 1989; 106: 675-684
        • Lebeau G
        • Yanaga K
        • Marsh JW
        • Tzakis AG
        • Makowka L
        • Gordon RD
        • et al.
        Analysis of surgical complications after 397 hepatic transplantations.
        Surg Gynecol Obstet. 1990; 170: 317-322
        • D'Alessandro AM
        • Kalayoglu M
        • Pirsh JD
        • Sollinger HW
        • Reed A
        • Knechtle SJ.
        Biliary tract complications after orthotopic liver transplantation.
        Transplant Proc. 1991; 23: 1956
        • Donovan J.
        Non-surgical management of biliary tract diseases after liver transplantation.
        Gastroenterol Clin North Am. 1993; 22: 317-336
        • Cotton PB
        • Williams CB.
        Endoscopic retrograde cholangiopancreatography (ERCP).
        in: 3rd ed. Practical gastrointestinal endoscopy. Blackwell Scientific, London1990: 85-117
        • Cotton PB
        • Williams CB.
        Therapeutic endoscopic retrograde cholangio-pancreatography (ERCP).
        in: Practical gastrointestinal endoscopy. 3rd ed. Blackwell Scientific, London1990: 118-159
        • Johanson JF
        • Schmalz MJ
        • Geenen JE.
        Incidence and risk factors for biliary and pancreatic stent migration.
        Gastrointest Endosc. 1992; 38: 341-346
        • Humar A
        • Barron PT
        • Sekar ASC
        • Lum A.
        Pancreatitis and duodenal perforation as complications of an endoscopically placed biliary stent.
        Gastrointest Endosc. 1994; 40: 365-366
        • Ruffolo TA
        • Lehman GA
        • Sherman S
        • Aycock R
        • Hayes A.
        Biliary stent migration with colonic diverticular impaction.
        Gastrointest Endosc. 1992; 38: 81-83