title: Diagnostic value of ultrasound in detection of biliary tract complications after liver transplantation.
abstract: BACKGROUND
  Biliary complications are significant source of morbidity after liver transplantation (LT). Cholangiography is the gold standard for diagnosis and specification of biliary complications.
  
  
  OBJECTIVE
  Detailed analyses of ultrasound (US) as a safe imaging method in this regard are still lacking. Therefore we analyzed systematically the diagnostic value of US in these patients.
  
  
  METHODS
  Retrospectively, 128 liver graft recipients and their clinical data were analyzed. All patients had a standardized US examination. The findings of US were compared to cholangiographic results in 42 patients. Following statistical analyses were performed: descriptive statistics, sensitivity, specificity, positive and negative predictive values (PPV, NPV).
  
  
  RESULTS
  42 patients had 54 different biliary complications (Anastomotic stenosis (AS) n = 33, ischemic type biliary lesions (ITBL) n = 18 and leakage n = 3). US detected n = 22/42 (52%) patients with biliary complications. The sensitivity, specificity, PPV and NPV of US were: 61%, 100%, 100%, 79% (95CI, 36-86%) for ITBL and 24%, 100, 100%, 31% (95CI, 9-46 %) for AS, respectively.
  
  
  CONCLUSIONS
  US examination had no false positive rate. Therefore, it may be helpful as a first screening modality. But for the direct diagnosis of the biliary complication US is not sensitive enough.
authors.affiliation: Department of Gastroenterology, Hannover Medical School, Hannover, Germany.
authors.forename: Andrej
authors.initials: A
authors.lastname: Potthoff
authors.forename: Anreas
authors.initials: A
authors.lastname: Hahn
authors.forename: Stefan
authors.initials: S
authors.lastname: Kubicka
authors.forename: Andrea
authors.initials: A
authors.lastname: Schneider
authors.forename: Jochen
authors.initials: J
authors.lastname: Wedemeyer
authors.forename: Juergen
authors.initials: J
authors.lastname: Klempnauer
authors.forename: Michael
authors.initials: M
authors.lastname: Manns
authors.forename: Michael
authors.initials: M
authors.lastname: Gebel
authors.forename: Bita
authors.initials: B
authors.lastname: Boozari
keywords: Cholangiography; Complications; Liver transplantation