title: Results of endoscopic retrograde cholangiopancreatography in the treatment of biliary tract complications after orthotopic liver transplantation: our experience.
abstract: OBJECTIVE
  Biliary tract complications are a common cause of morbidity and mortality after orthotopic liver transplantation. We report our experience in the use of ERCP in the treatment of post liver transplantation biliary complications.
  
  
  METHODS
  Retrospectively we evaluated 34 patients who had undergone ERCP out of 460 who received a liver transplantation between January 1999 and December 2004. Eighteen patients presented biliary strictures, anastomotic in 12 cases and hilar in 6 cases; seven patients presented a biliary fistula and fifteen presented biliary stones in 8 cases associated to stricture and in 1 case to a fistula. Finally three patients underwent ERCP do to jaundice. The 18 patients with biliary strictures underwent sphincterotomy, dilation and stenting; the seven cases with fistulas were treated with a plastic biliary stent without sphincterotomy and the patients with biliary stones underwent sphincterotomy and endoscopic toilette of the common bile duct.
  
  
  RESULTS
  An ERCP success rate of 97.7% was achieved without any significant complications. We obtained the resolution of all the biliary anastomotic strictures; resolution of hilar strictures was obtained in 66.6%. Biliary leak healed in 85.7% of patients. Complete endoscopic toilette was achieved in all the patients with biliary stones.
  
  
  CONCLUSIONS
  In our experience ERCP has proved to be safe and effective in the treatment of post liver transplant biliary complications.
authors.affiliation: Division of Gastroenterology, Policlinic Hospital Sant'Orsola-Malpighi, Bologna. solmil@aosp.bo.it
authors.forename: Luigi
authors.initials: L
authors.lastname: Solmi
authors.forename: Giulio
authors.initials: G
authors.lastname: Cariani
authors.forename: Pietro
authors.initials: P
authors.lastname: Leo
authors.forename: Anna
authors.initials: A
authors.lastname: Miracolo
authors.forename: Giovanni
authors.initials: G
authors.lastname: Nigro
authors.forename: Enrico
authors.initials: E
authors.lastname: Roda
mesh_terms: D000328:Adult; D001660:Biliary Tract Diseases / Q000209:etiology / Q000601:surgery*; D001662:Biliary Tract Surgical Procedures; D002760:Cholangiopancreatography, Endoscopic Retrograde; D005260:Female; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology / Q000601:surgery*; D016896:Treatment Outcome