title: Endoscopic treatment of post-liver transplantation biliary leaks with stent placement across the leak site.
abstract: BACKGROUND
  Biliary tract leaks occur in over 10% of patients undergoing liver transplantation and are the most common cause of biliary tract-related death in these patients. A number of treatment options are available, but a standard approach has not been established.
  
  
  METHODS
  Twenty-six patients were retrospectively studied who had post-transplantation leaks develop with special reference to those who underwent endoscopic placement of a "leak-bridging" stent.
  
  
  RESULTS
  Endoscopic retrograde cholangiography was performed in all cases with no procedure-related complications. Twenty-four patients had a leak-bridging stent, 1 a transpapillary stent, and 1 a nasobiliary drain. Leak resolution occurred in 23 cases (88%) after initial stent placement. The median time to stent removal was 8 weeks. Three patients did not respond to initial treatment; 2 were successfully treated with another stent and a single patient required surgical repair. Four deaths occurred during follow-up, all unrelated to the biliary leak.
  
  
  CONCLUSIONS
  Placement of a leak-bridging stent is a safe and effective initial treatment for post-liver transplantation biliary leaks.
authors.affiliation: Division of Gastroenterology and Hepatology, Digestive Disease Center, Medical University of South Carolina, 96 Jonathan Lucas Blvd., Charleston, SC 29425, USA.
authors.forename: J
authors.initials: J
authors.lastname: Morelli
authors.forename: H E
authors.initials: HE
authors.lastname: Mulcahy
authors.forename: I R
authors.initials: IR
authors.lastname: Willner
authors.forename: P
authors.initials: P
authors.lastname: Baliga
authors.forename: K D
authors.initials: KD
authors.lastname: Chavin
authors.forename: R
authors.initials: R
authors.lastname: Patel
authors.forename: M
authors.initials: M
authors.lastname: Payne
authors.forename: P B
authors.initials: PB
authors.lastname: Cotton
authors.forename: R
authors.initials: R
authors.lastname: Hawes
authors.forename: A
authors.initials: A
authors.lastname: Reuben
authors.forename: J T
authors.initials: JT
authors.lastname: Cunningham
mesh_terms: D001646:Bile; D001652:Bile Ducts; D002760:Cholangiopancreatography, Endoscopic Retrograde; D005260:Female; D006801:Humans; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000628:therapy*; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome