Gut Liver.  2015 May;9(3):417-423. 10.5009/gnl14117.

Endoscopic Management of Bile Leakage after Liver Transplantation

• Oh D
• Lee SK
• Song TJ
• Park DH
• Lee SS
• Seo DW
• Kim MH

• KMID: 2155651
• DOI: http://doi.org/10.5009/gnl14117

Abstract

BACKGROUND/AIMS
Endoscopic retrograde cholangiopancreatography (ERCP) can be an effective treatment for bile leakage after liver transplantation. We evaluated the efficacy of endoscopic treatment in liver transplantation in patients who developed bile leaks.
METHODS
Forty-two patients who developed bile leaks after liver transplantation were included in the study. If a bile leak was observed on ERCP, a sphincterotomy was performed, and a nasobiliary catheter was then inserted. If a bile leak was accompanied by a bile duct stricture, either the stricture was dilated with balloons, followed by nasobiliary catheter insertion across the bile duct stricture, or endoscopic retrograde biliary drainage was performed.
RESULTS
In the bile leakage alone group (22 patients), endoscopic treatment was technically successful in 19 (86.4%) and clinically successful in 17 (77.3%) cases. Among the 20 patients with bile leaks with bile duct strictures, endoscopic treatment was technically successful in 13 (65.0%) and clinically successful in 10 (50.0%) cases. Among the 42 patients who underwent ERCP, technical success was achieved in 32 (76.2%) cases and clinical success was achieved in 27 (64.3%) cases.
CONCLUSIONS
ERCP is an effective and safe therapeutic modality for bile leaks after liver transplantation. ERCP should be considered as an initial therapeutic modality in post-liver transplantation patients.

Keyword

Cholangiopancreatography, endoscopic retrograde; Bile leakage; Liver transplantation

MeSH Terms

Adult
Anastomotic Leak/etiology/*surgery
*Bile
Biliary Tract Diseases/etiology/*surgery
Cholangiopancreatography, Endoscopic Retrograde/*methods
Constriction, Pathologic/therapy
Drainage
Female
Humans
*Liver Transplantation
Male
Middle Aged
Stents
Treatment Outcome
Young Adult