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Gastrointest Endosc. 1995 Dec;42(6):527-34.

Diagnostic and therapeutic endoscopic retrograde cholangiography after liver transplantation.

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1
Service Medico-Chirurgical de Gastroenterologie et d'Hepato-Pancreatologie, Université Libre de Bruxelles, Belgique.

Abstract

BACKGROUND:

We report our current experience using endoscopic retrograde cholangiography in the management of post-transplantation biliary tract complications.

METHODS:

Twenty-three patients among 109 adult liver transplant recipients underwent retrograde cholangiography because of cholestasis (18 patients) or bile leaks (5 patients).

RESULTS:

Eleven of 18 patients developed anastomotic strictures, all successfully dilated by plastic stents; one patient required Roux-en-Y revision due to recurrent cholangitis while stented. Three had biliary calculi extracted following sphincterotomy. Two developed intrahepatic ductal strictures secondary to severe rejection. One patient had hepatic artery thrombosis with a hilar stricture. One cholangiogram was normal. Three patients developed bile peritonitis following T-tube removal, all treated by sphincterotomy and nasobiliary drainage. Choledochal perforation resulting from an impacted T-tube limb was detected in two patients, both treated with sphincterotomy and nasobiliary drainage.

CONCLUSIONS:

Strictures within 3 months of surgery required 3 months of stenting; those occurring later required longer periods of time to respond. Bile leaks responded uniformly and rapidly to drainage. Endoscopic retrograde cholangiography is a useful diagnostic and therapeutic intervention for post-transplantation biliary tract complications.

PMID:
8674922
[Indexed for MEDLINE]
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