Biliary Complications after Liver Transplant: Timeline, Spectrum, Management Algorithm, and Prevention

Biliary complications are the most common complications seen after liver transplantation (LT) with an incidence ranging between 10 and 15% and increasing in the setting of increased access to living donor liver transplant and utilization of marginal grafts. Among the biliary complications, the most...

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Main Authors: Akash Roy, Mahesh Kumar Goenka
Format: Article
Language:English
Published: Thieme Medical and Scientific Publishers Pvt. Ltd. 2024-12-01
Series:Journal of Digestive Endoscopy
Subjects:
Online Access:http://www.thieme-connect.de/DOI/DOI?10.1055/s-0044-1793839
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author Akash Roy
Mahesh Kumar Goenka
author_facet Akash Roy
Mahesh Kumar Goenka
author_sort Akash Roy
collection DOAJ
description Biliary complications are the most common complications seen after liver transplantation (LT) with an incidence ranging between 10 and 15% and increasing in the setting of increased access to living donor liver transplant and utilization of marginal grafts. Among the biliary complications, the most common are anastomotic strictures, nonanastomotic strictures, and biliary leaks, which have a variable time of presentation posttransplant. The risk factors for the development of biliary complications include surgical techniques, type of grafts, prolonged ischemia, primary disease etiology, and associated post-LT complications. The approach to a diagnosis in an appropriate clinical setting involves a stepwise approach involving clinical history, assessment of risk factors, biochemical abnormalities, and appropriate imaging. Therapeutic options revolve around endoscopic retrograde cholangiopancreatography and percutaneous transhepatic biliary drainage, with surgical intervention being reserved in case of failure of these modalities. Preventive strategies with machine perfusion techniques are promising, while use of T-tubes for prevention of complications remains controversial.
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institution Kabale University
issn 0976-5042
0976-5050
language English
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publisher Thieme Medical and Scientific Publishers Pvt. Ltd.
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spelling doaj-art-e22f8667fb1d42cb86a1d7f06b366e342024-12-30T23:36:02ZengThieme Medical and Scientific Publishers Pvt. Ltd.Journal of Digestive Endoscopy0976-50420976-50502024-12-01150423524210.1055/s-0044-1793839Biliary Complications after Liver Transplant: Timeline, Spectrum, Management Algorithm, and PreventionAkash Roy0Mahesh Kumar Goenka1Institute of Gastrosciences and Liver Transplantation, Apollo Multispeciality Hospitals, Kolkata, West Bengal, IndiaInstitute of Gastrosciences and Liver Transplantation, Apollo Multispeciality Hospitals, Kolkata, West Bengal, IndiaBiliary complications are the most common complications seen after liver transplantation (LT) with an incidence ranging between 10 and 15% and increasing in the setting of increased access to living donor liver transplant and utilization of marginal grafts. Among the biliary complications, the most common are anastomotic strictures, nonanastomotic strictures, and biliary leaks, which have a variable time of presentation posttransplant. The risk factors for the development of biliary complications include surgical techniques, type of grafts, prolonged ischemia, primary disease etiology, and associated post-LT complications. The approach to a diagnosis in an appropriate clinical setting involves a stepwise approach involving clinical history, assessment of risk factors, biochemical abnormalities, and appropriate imaging. Therapeutic options revolve around endoscopic retrograde cholangiopancreatography and percutaneous transhepatic biliary drainage, with surgical intervention being reserved in case of failure of these modalities. Preventive strategies with machine perfusion techniques are promising, while use of T-tubes for prevention of complications remains controversial.http://www.thieme-connect.de/DOI/DOI?10.1055/s-0044-1793839anastomotic stricturenonanastomotic stricturebiliary leak
spellingShingle Akash Roy
Mahesh Kumar Goenka
Biliary Complications after Liver Transplant: Timeline, Spectrum, Management Algorithm, and Prevention
Journal of Digestive Endoscopy
anastomotic stricture
nonanastomotic stricture
biliary leak
title Biliary Complications after Liver Transplant: Timeline, Spectrum, Management Algorithm, and Prevention
title_full Biliary Complications after Liver Transplant: Timeline, Spectrum, Management Algorithm, and Prevention
title_fullStr Biliary Complications after Liver Transplant: Timeline, Spectrum, Management Algorithm, and Prevention
title_full_unstemmed Biliary Complications after Liver Transplant: Timeline, Spectrum, Management Algorithm, and Prevention
title_short Biliary Complications after Liver Transplant: Timeline, Spectrum, Management Algorithm, and Prevention
title_sort biliary complications after liver transplant timeline spectrum management algorithm and prevention
topic anastomotic stricture
nonanastomotic stricture
biliary leak
url http://www.thieme-connect.de/DOI/DOI?10.1055/s-0044-1793839
work_keys_str_mv AT akashroy biliarycomplicationsafterlivertransplanttimelinespectrummanagementalgorithmandprevention
AT maheshkumargoenka biliarycomplicationsafterlivertransplanttimelinespectrummanagementalgorithmandprevention