title: Role of endoscopic retrograde cholangiopancreatography in the diagnosis and treatment of biliary tract complications after orthotopic liver transplantation.
abstract: BACKGROUND
  Biliary complications are a major drawback of liver transplantation.
  
  
  OBJECTIVE
  To analyse, in a single centre, experience in endoscopic diagnosis and management of biliary complications after liver transplantation.
  
  
  METHODS
  A total of 147 consecutive liver transplantations performed on 132 patients over a 5-year period.
  
  
  METHODS
  Evaluation of the incidence and type of biliary-related complications and analysis of their diagnosis and endoscopic treatment by cholangiopancreatography in terms of success of the endoscopic approach, conversion to surgery and long-term patient and graft survival.
  
  
  RESULTS
  Endoscopic retrograde cholangiopancreatography was performed on 30 patients (23%). Overall incidence of biliary complications as confirmed by endoscopic retrograde cholangiopancreatography was 17% (25 cases). Endoscopic retrograde cholangiopancreatography was negative in 5 cases (16%). Biliary complications were successfully treated by endoscopy in 84% of cases (21 out of 25 patients); 4 cases (16%) required a surgical approach (2 choledochojejunostomy, 2 retransplantation) due to failure to correct the problem endoscopically. Stenoses and biliary sludge associated with retained internal stent were almost always successfully managed by endoscopic retrograde cholangiopancreatography, while anastomotic leakage more frequently required a surgical approach.
  
  
  CONCLUSIONS
  Endoscopic retrograde cholangiopancreatography is a safe and effective approach for diagnosis and treatment of biliary-related complications after liver transplantation thereby reducing morbidity and mortality related to re-operation which is, however, required in selected cases.
authors.affiliation: Department of Surgery Transplantation, University of Udine, Italy. umberto.baccarani@dsc.uniud.it
authors.forename: U
authors.initials: U
authors.lastname: Baccarani
authors.forename: A
authors.initials: A
authors.lastname: Risaliti
authors.forename: L
authors.initials: L
authors.lastname: Zoratti
authors.forename: M
authors.initials: M
authors.lastname: Zilli
authors.forename: P
authors.initials: P
authors.lastname: Brosola
authors.forename: V
authors.initials: V
authors.lastname: Vianello
authors.forename: G
authors.initials: G
authors.lastname: de Pretis
authors.forename: F
authors.initials: F
authors.lastname: Bresadola
mesh_terms: D001660:Biliary Tract Diseases / Q000000981:diagnostic imaging* / Q000209:etiology / Q000601:surgery / Q000628:therapy*; D002760:Cholangiopancreatography, Endoscopic Retrograde; D005260:Female; D006085:Graft Survival; D006801:Humans; D016031:Liver Transplantation; D008297:Male; D011183:Postoperative Complications