[Role of surgery in the management of biliary complications after liver transplantation].
Management of biliary tract complications (BTC) after liver transplantation (LT) has progressed in recent years. The aims of this study were, to analyse the incidence and management in our institution of BTC after 1000 LT; and to study the management of patients with anastomotic strictures (AS).


RESULTS
The incidence of BTC was 23%. There were 76 cases of bile leak, 106 cases of anastomotic strictures, 46 non-anastomotic strictures, 42 choledocolithiasis and 19 other complications. Among 106 cases of anastomotic strictures, radiological treatment, either PTC or ERCP, was initially indicated in 62. The AS of 38 patients (33%) were resolved with surgical treatment, 18 of them after a previous attempt at radiological treatment. Patients who were treated initially by radiologically required more procedures. Morbidity and mortality related to BTC were slightly higher in the group of patients treated by radiology (morbidity: surgical: 4 (18%) vs. radiological: 20 (32%); p=0.2 and mortality: surgical: 0% vs. radiological: 8 (11%); p=0.23). Among 46 patients with non-anastomotic strictures, 29 were resolved with retransplantation (63%).


CONCLUSIONS
Surgery has a significant role in the management of BTC, and is the treatment of choice in some cases of anastomotic strictures. Retransplantation may be the preferred option in patients with non-anastomotic strictures.
Lladó
Laura
L
Departmento de Cirugía, Unidad Trasplante Hepático, Hospital Universitario de Bellvitge, Barcelona, Spain. 31513llg@comb.cat
Fabregat
Joan
J
Ramos
Emilio
E
Baliellas
Carme
C
Torras
Jaume
J
Julià
David
D
Berrozpe
Ana
A
Jorba
Rosa
R
Rafecas
Antoni
A
D001660:Biliary Tract Diseases / Q000209:etiology* / Q000601:surgery*; D005260:Female; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies