Management of biliary complications after liver transplantation

Richard R. Lopez, Kent G. Benner, Krassi Ivancev, Emmet B. Keeffe, Clifford Deveney, C. Wright Pinson

Research output: Contribution to journalArticle

100 Citations (Scopus)

Abstract

Biliary tract complications after liver transplantation are common, and the evaluation of newer treatment options compared with standard surgical treatment is important. In 62 liver transplants performed in 55 adult patients, the biliary tract was reconstructed with choledochocholedochostomy (CC) in 52 (84%) and Roux-en-Y choledochojejunostomy (RYCJ) in 10 (16%). Seventeen biliary tract complications occurred in 16 patients (29%). The incidence of complications was the same after CC and RYCJ. Eight complications (47%) occurred within the first month and nine (53%) thereafter. Only 6 of 17 (35%) biliary tract complications required operation. One patient died of a biliary tract complication. No other allografts were lost due to biliary tract complications. Four patients transplanted at other centers were also treated, for a total of 21 biliary tract complications. Overall, there were nine bile leaks, eight bile duct strictures, two Roux loop hemorrhages, one choledocholithiasis, and one ampullary dyskinesia. Temporary or permanent stents were used successfully in seven of eight strictures. Five bile leaks were managed without operation. Nonsurgical management is appropriate for a selected majority of patients with late bile leaks, biliary tract strictures, or choledocholithiasis after liver transplantation.

Original languageEnglish (US)
Pages (from-to)519-524
Number of pages6
JournalThe American Journal of Surgery
Volume163
Issue number5
DOIs
StatePublished - 1992

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Biliary Tract
Liver Transplantation
Bile
Choledochostomy
Choledocholithiasis
Pathologic Constriction
Dyskinesias
Bile Ducts
Stents
Allografts
Hemorrhage
Transplants
Liver
Incidence
Therapeutics

ASJC Scopus subject areas

  • Surgery

Cite this

Lopez, R. R., Benner, K. G., Ivancev, K., Keeffe, E. B., Deveney, C., & Pinson, C. W. (1992). Management of biliary complications after liver transplantation. The American Journal of Surgery, 163(5), 519-524. https://doi.org/10.1016/0002-9610(92)90401-C

Management of biliary complications after liver transplantation. / Lopez, Richard R.; Benner, Kent G.; Ivancev, Krassi; Keeffe, Emmet B.; Deveney, Clifford; Pinson, C. Wright.

In: The American Journal of Surgery, Vol. 163, No. 5, 1992, p. 519-524.

Research output: Contribution to journalArticle

Lopez, RR, Benner, KG, Ivancev, K, Keeffe, EB, Deveney, C & Pinson, CW 1992, 'Management of biliary complications after liver transplantation', The American Journal of Surgery, vol. 163, no. 5, pp. 519-524. https://doi.org/10.1016/0002-9610(92)90401-C
Lopez, Richard R. ; Benner, Kent G. ; Ivancev, Krassi ; Keeffe, Emmet B. ; Deveney, Clifford ; Pinson, C. Wright. / Management of biliary complications after liver transplantation. In: The American Journal of Surgery. 1992 ; Vol. 163, No. 5. pp. 519-524.
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