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 Rouxen- Y choledocho-jejunostomy or extracorporeal shock wave lithotripsy for difficult stones.

Lisotti, A., Fusaroli, P., Caletti, G. (2015). Role of endoscopy in the conservative management of biliary complications after deceased donor liver transplantation. WORLD JOURNAL OF HEPATOLOGY, 7(30), 2927-2932 [10.4254/wjh.v7.i30.2927].

Role of endoscopy in the conservative management of biliary complications after deceased donor liver transplantation

LISOTTI, ANDREA;FUSAROLI, PIETRO;CALETTI, GIANCARLO
2015

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 Rouxen- Y choledocho-jejunostomy or extracorporeal shock wave lithotripsy for difficult stones.
2015
Lisotti, A., Fusaroli, P., Caletti, G. (2015). Role of endoscopy in the conservative management of biliary complications after deceased donor liver transplantation. WORLD JOURNAL OF HEPATOLOGY, 7(30), 2927-2932 [10.4254/wjh.v7.i30.2927].
Lisotti, Andrea; Fusaroli, Pietro; Caletti, Giancarlo
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11585/547674
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