[Prophylaxis and management of biliary complications after orthotopic liver transplantation].
OBJECTIVE
To investigate the risk factors of biliary complications after orthotopic liver transplantation (OLTx) and the relevant prevention and management strategies.


METHODS
The clinical data of 368 patients undergoing allograft orthotopic liver transplantation, 282 males and 86 females, aged 47.5 (8 - 73), were collected and analyzed retrospectively.


RESULTS
Of the 368 OLTx patients, 36 (9.8%) experienced biliary complications, including simple anastomosis biliary leakage (7 cases), biliary leakage due to injury and omission of accessory hepatic duct (1 case), anastomosis stricture (5 cases), intrahepatic bile duct stricture (3 cases), bile duct stricture secondary to bile duct twist (1 case), calculus of intrahepatic duct (2 cases), bile duct stricture secondary to biliary leakage (2 cases), bile duct stricture combined with intrahepatic biloma (2 cases), bile duct stricture combined with biliary sludge (2 cases), biliary cast syndrome (5 cases), hemobilia (1 case), intrahepatic abscess (3 cases) and Oddi's sphincter dysfunction (2 cases). Among the 36 patients with biliary complications, 23 were cured by nonsurgical therapies; and 13 patients needed abdominal surgical interventions, including retransplantation in 7 cases.


CONCLUSIONS
Biliary complications after OLT are difficult to treat. Most of these complications can be cured conservatively, such as radiological intervention and endoscopic treatment. When the patients are unresponsive to nonsurgical therapies, or when they suffer from hepatic arterial embolism or arterial stricture simultaneously, surgical interventions, even retransplantation should be considered.
Ma
Yi
Y
Department of Transplantation Surgery, First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China.
He
Xiao-Shun
XS
Zhu
Xiao-Feng
XF
Wang
Guo-Dong
GD
Wang
Dong-Ping
DP
Ju
Wei-Qiang
WQ
Wu
Lin-Wei
LW
Hu
An-Bin
AB
Tai
Qiang
Q
D000293:Adolescent; D000328:Adult; D000368:Aged; D001658:Biliary Fistula / Q000209:etiology / Q000517:prevention & control*; D001660:Biliary Tract Diseases / Q000209:etiology / Q000517:prevention & control*; D002648:Child; D005260:Female; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control*; D012307:Risk Factors