title: Biliary complications after pediatric liver transplantation.
abstract: OBJECTIVE
  After liver transplantation, biliary complications are more prevalent in pediatric patients, with reported rates varying between 15% and 30%.
  
  
  METHODS
  We retrospectively analyzed biliary complications observed in 84 pediatric liver transplantation patients between July 2006 and September 2012. Biliary reconstruction was accomplished via a duct-to-duct anastomosis in 5 (83.3%) of the 6 patients receiving whole liver grafts and in 44 (56.4%) of the 78 patients who received a segmental live donor graft. For the remaining 34 patients with living donor and 1 patient with whole liver graft, Roux-en-Y hepaticojejunostomy was the preferred method.
  
  
  RESULTS
  Post-transplantation biliary complications were encountered in 26 patients (30.1%). The biliary complication rate was 38% in 49 duct-to-duct anastomosis, whereas it was 20% in the hepaticojejunostomy group consisting of 35 recipients. Thirteen of the 18 biliary leaks were from duct-to-duct anastomoses and the remaining 5 were from the hepaticojejunostomies and 6 of the 8 biliary strictures were observed in recipients with duct-to-duct anastomosis. In 19 of the 26 patients, the biliary complications were successfully treated with interventional radiologic procedures and 1 was treated with stent placement during endoscopic retrograde cholangiopancreatography.
  
  
  CONCLUSIONS
  Percutaneous interventional procedures are valuable, effective, and life-saving therapeutic alternatives for the treatment of bile leaks and strictures after pediatric liver transplantations.
authors: Department of General Surgery, Baskent University Faculty of Medicine, Ankara, Turkey. Electronic address: fezaykar@yahoo.com.
authors: F
authors: F
authors: Karakayalı
authors: M
authors: M
authors: Kırnap
authors: A
authors: A
authors: Akdur
authors: N
authors: N
authors: Tutar
authors: F
authors: F
authors: Boyvat
authors: G
authors: G
authors: Moray
authors: M
authors: M
authors: Haberal
mesh_terms: D000293:Adolescent; D000367:Age Factors; D057868:Anastomotic Leak / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D001662:Biliary Tract Surgical Procedures / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000295:instrumentation; D002779:Cholestasis / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D003251:Constriction, Pathologic; D005260:Female; D006801:Humans; D007582:Jejunostomy / Q000009:adverse effects; D016031:Liver Transplantation / Q000009:adverse effects* / Q000379:methods; D008297:Male; D015641:Radiography, Interventional; D019651:Plastic Surgery Procedures / Q000009:adverse effects*; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome