Endoscopic treatment of post-liver transplantation biliary leaks with stent placement across the leak site

Joseph Morelli, Hugh E. Mulcahy, Ira R. Willner, Prabhakar Baliga, Kenneth D. Chavin, Rig Patel, Mark Payne, Peter B. Cotton, Robert Hawes, Adrian Reuben, John T. Cunningham

Research output: Contribution to journalArticlepeer-review

61 Scopus citations

Abstract

Background: Biliary tract leaks occur in over 10% of patients undergoing liver transplantation and are the most common cause of biliary tract-related death in these patients. A number of treatment options are available, but a standard approach has not been established. Methods: Twenty-six patients were retrospectively studied who had post-transplantation leaks develop with special reference to those who underwent endoscopic placement of a "leak-bridging" stent. Results: Endoscopic retrograde cholangiography was performed in all cases with no procedure-related complications.Twenty-four patients had a leak-bridging stent, 1 a transpapillary stent, and 1 a nasobiliary drain. Leak resolution occurred in 23 cases (88%) after initial stent placement. The median time to stent removal was 8 weeks. Three patients did not respond to initial treatment; 2 were successfully treated with another stent and a single patient required surgical repair. Four deaths occurred during follow-up, all unrelated to the biliary leak. Conclusions: Placement of a leak-bridging stent is a safe and effective initial treatment for post-liver transplantation biliary leaks.

Original languageEnglish (US)
Pages (from-to)471-475
Number of pages5
JournalGastrointestinal endoscopy
Volume54
Issue number4
DOIs
StatePublished - Oct 2001

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Gastroenterology

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