[Nonvascular interventional radiology in the treatment of post-liver transplant complications. The clinico-radiological correlations and technical considerations].
Eleven patients, included in a series of 105 orthotopic liver transplant recipients, underwent interventional radiologic procedures for post-operative complications. Seven patients had obstructive jaundice, three patients had sepsis, and one patient was bleeding from the T-tube. Cholangiography, performed in 9/11 patients, demonstrated stenosis of the anastomosis in six cases, stenosis of the intrahepatic biliary tree in one case, and stenosis of both tracts in the remaining two cases. Four patients were treated with bilioplasty (from 1 to 5 sessions), using balloon catheters (8-10 mm) followed by stones removal in one case, and by the placement of a metallic stent in another case. The follow-up ranged from one to three years: no biliary stasis occurred, during that period, in these patients. Another patient with recurrent cholangiocarcinoma of the biliary anastomosis, treated with Carey-Coons endoprosthesis and brachytherapy, died four months later without jaundice. In the three patients with sepsis and in the patient with bleeding from the T-tube, intra- or extra-hepatic (in one case) multiple abscesses were demonstrated. The conservative treatment with the placement of percutaneous drainage catheters, associated with internal biliary drainage in two cases, allowed complete symptoms resolution. The technical success obtained in all patients confirmed the effectiveness of interventional radiology in the treatment of biliary complications after liver transplant, thus avoiding the need of surgical reintervention.
Rossi
M
M
III Cattedra, Istituto di Radiologia, Università degli Studi di Roma La Sapienza.
Salvatori
F M
FM
Ingianna
D
D
Greco
M
M
Iappelli
M
M
Rossi
P
P
D002758:Cholangiography; D003287:Contrast Media; D004322:Drainage / Q000295:instrumentation / Q000379:methods; D005500:Follow-Up Studies; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects / Q000000981:diagnostic imaging*; D011183:Postoperative Complications / Q000000981:diagnostic imaging* / Q000628:therapy*; D015641:Radiography, Interventional / Q000379:methods*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D003287:Contrast Media