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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| Format: | Article |
| Language: | English |
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Thieme Medical and Scientific Publishers Pvt. Ltd.
2024-12-01
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| Series: | Journal of Digestive Endoscopy |
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| 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. |
| format | Article |
| id | doaj-art-e22f8667fb1d42cb86a1d7f06b366e34 |
| institution | Kabale University |
| issn | 0976-5042 0976-5050 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Thieme Medical and Scientific Publishers Pvt. Ltd. |
| record_format | Article |
| series | Journal of Digestive Endoscopy |
| 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 |