Post-Transplant Biliary Strictures: An Updated Review

Abstract

Liver transplantation (LT) is the only curative therapy in patients with end-stage liver disease with excellent long-term survival; however, LT recipients are at risk of significant complications. Among these complications are biliary complications with an incidence ranging from 5 to 32% and associated with significant post-LT morbidity and mortality. Prompt recognition and management are critical as these complications have been associated with mortality rates up to 19% and retransplantation rates up to 13%. An important limitation of published studies is that a large proportion does not discriminate between anastomotic strictures and nonanastomotic strictures. This review aims to summarize our current understanding of risk factors and natural history, diagnostic testing, and treatment options for post-LT biliary strictures.

Management of post-liver transplantation biliary stricture inaccessible by endoscopic retrograde cholangiopancreatography: A case report

“…Post-LT biliary strictures are often complex, associated with recurrences, and inaccessible by ERCP. Numerous studies have demonstrated that the treatment of complex post-LT biliary strictures requires multiple modalities, including interventional radiologic and endoscopic techniques[ 4 ]. A recent meta-analysis displayed that multiple plastic stents and removable FC-SEMSs are equally effective and safe procedures for managing refractory biliary strictures or as primary treatment[ 5 ].…”