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KMID : 1188320150090030417
Gut and Liver
2015 Volume.9 No. 3 p.417 ~ p.423
Endoscopic Management of Bile Leakage after Liver Transplantation
Oh Dong-wook

Lee Sung-Koo
Song Tae-Jun
Park Do-Hyun
Lee Sang-Soo
Seo Dong-Wan
Kim Myung-Hwan
Abstract
Background/Aims:Endoscopic retrograde cholangiopancreatography (ERCP) can be an effective treatment for bile leakage after liver transplantation. We evaluated the efficacy of endoscopic treatment in liver transplantation in patients who developed bile leaks.

Methods:Forty-two patients who developed bile leaks after liver transplantation were included in the study. If a bile leak was observed on ERCP, a sphincterotomy was performed, and a nasobiliary catheter was then inserted. If a bile leak was accompanied by a bile duct stricture, either the stricture was dilated with balloons, followed by nasobiliary catheter insertion across the bile duct stricture, or endoscopic retrograde biliary drainage was performed.

Results:In the bile leakage alone group (22 patients), endoscopic treatment was technically successful in 19 (86.4%) and clinically successful in 17 (77.3%) cases. Among the 20 patients with bile leaks with bile duct strictures, endoscopic treatment was technically successful in 13 (65.0%) and clinically successful in 10 (50.0%) cases. Among the 42 patients who underwent ERCP, technical success was achieved in 32 (76.2%) cases and clinical success was achieved in 27 (64.3%) cases.

Conclusions:ERCP is an effective and safe therapeutic modality for bile leaks after liver transplantation. ERCP should be considered as an initial therapeutic modality in post-liver transplantation patients.
KEYWORD
Cholangiopancreatography, endoscopic retrograde, Bile leakage, Liver transplantation
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