Tung BY, Kimmey MB. Biliary complications of orthotopic liver transplantation. Dig Dis 1999;17(3):133-44
Division of Gastroenterology, University of Washington School of Medicine, Seattle, USA.
Biliary complications
are a common cause of morbidity following orthotopic liver transplantation.
Complications involving the biliary tree occur after 6-34% of
all liver transplants performed, usually within the first 3 months
after transplantation. Bile leaks and biliary strictures are the
most common biliary complications, but sphincter of Oddi dysfunction,
hemobilia, and biliary obstruction from stones, sludge, or casts
have also been described. The risk of specific biliary complications
is related to the type of biliary reconstruction performed at
the time of transplantation. In this article, we review the major
types of biliary reconstruction and their associated biliary complications.
Specific risk factors for the development of biliary complications
are outlined. Finally, the management of biliary complications
is discussed, with an emphasis on the role of endoscopic therapy.
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