Endoscopic treatment of biliary complications after liver transplantation: Analytic review

The data available shows that the rate of biliary complications in transplant recipients ranges between 8% and 35%, but this rate of complications is higher for living-related liver transplantation (LRLTx) than orthotopic liver transplantation (OLTx). Biliary complications may include: stricture, biliary leaks, stones or debris and Oddi dysfunction. The aim of this paper was to analyze the results of endoscopic treatments on biliary complications after liver transplantation. This article is a review of available published data on the results of endoscopic treatment of post transplant biliary complication. In patients with duct-to-duct anastomosis, the ERCP is safe and effective in the diagnosis and management of biliary complications and avoids in the majority of cases percutaneous transhepatic approach or surgical interventions; whether unsuccessful, the ERCP does not negatively affects the surgical intervention, so a trial of endoscopic therapy should be performed to delay or defer a post-transplantation surgical procedure.