title: Role of endoscopy in the conservative management of biliary complications after deceased donor liver transplantation.
abstract: The clinical outcome of patients receiving liver transplantation could be significantly affected by biliary complications, including strictures, leaks, stones and bilomas; early diagnosis and treatment of these conditions lead to markedly reduction in morbidity and mortality. Therapeutic gold standard is represented by conservative approaches, both endoscopic and percutaneous, based on the type of biliary reconstruction, the local availability of the procedures and specific expertise. In patients with previous transplantation, the difficult biliary access and the possible presence of concomitant complications (mainly strictures) further restrict the efficacy of the endoscopic and percutaneous treatments; on the other hand, surgery should generally be avoided because of the even increased morbidity and mortality due to technical and clinical issues. Here we review the most common biliary complications occurring after liver transplantation and discuss available treatment options including future perspectives such as endoscopic ultrasound-guided biliary access in patients with Roux-en-Y choledocho-jejunostomy or extracorporeal shock wave lithotripsy for difficult stones.
authors.affiliation: Andrea Lisotti, Unità Operativa di Gastroenterologia, Ospedale Nuovo di Imola, 40026 Imola, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Lisotti
authors.affiliation: Andrea Lisotti, Unità Operativa di Gastroenterologia, Ospedale Nuovo di Imola, 40026 Imola, Italy.
authors.forename: Pietro
authors.initials: P
authors.lastname: Fusaroli
authors.affiliation: Andrea Lisotti, Unità Operativa di Gastroenterologia, Ospedale Nuovo di Imola, 40026 Imola, Italy.
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Caletti
keywords: Biliary drainage; Endoscopic retrograde cholangiopancreatography; Endoscopic ultrasonography; Endoscopic ultrasound; Percutaneous trans-hepatic drainage