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GAZZETTA MEDICA ITALIANA ARCHIVIO PER LE SCIENZE MEDICHE
A Journal on Internal Medicine and Pharmacology
Indexed/Abstracted in: BIOSIS Previews, EMBASE, Scopus, Emerging Sources Citation Index
Gazzetta Medica Italiana Archivio per le Scienze Mediche 2010 October;169(5):255-60
Endoscopic treatment of biliary complications after liver transplantation: analytic review
Tarantino I., Barresi L., Traina M., Gruttadauria S., Gridelli B.
1 Departement of Gastroenterology, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IsMeTT)
University of Pittsburgh Medical Center Palermo, Italy
2 Department of Transplantation Surgery, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IsMeTT) University of Pittsburgh Medical Center, Palermo, Italy
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.