| Abstract: |
Background: Complications involving the biliary tract after Orthotopic Liver Transplantation (OLT) are a significant source of morbidity and mortality. They have been reported to occur in 10% to 20% of all deceased-donor full-size OLT. There is a wide range of potential biliary complications. Their incidence varies according to the type of graft, donor, and biliary anastomosis. The most common biliary complications consist of bile duct leaks, anastomotic, non-anastomotic and intrahepatic strictures, stones, and ampullary dysfunction. Leaks predominate in the early post-transplant period whereas stricture formation typically develops gradually over time. In the study of one-third of biliary complications occurred within 1 month after surgery, and 80% within 6 months. Beside the postoperative bile duct leakage, non-anastomotic and anastomotic biliary strictures represent the most common biliary complications. Both types of strictures have their own localization and pathogenesis. Bile duct strictures, localized at the level of the end-to-end anastomosis of the donor and recipient bile ducts, non-anastomotic strictures are localized at the hilar bifurcation and/or at the more peripheral intrahepatic bile ducts, and are considered as an ischemic type of biliary lesions. Treatment modalities have also changed over the past years towards a primarily nonoperative, endoscopy-based strategy, leaving surgery for lesions which, otherwise, are not curable.Objective: To define the patient population that developed biliary complications and to compare them with the total group of transplanted patients. To characterize the different types of biliary complications with their symptomatology, radiological appearance and evolution. To explore the risk factors responsible for the most common biliary complication post-OLT. To evaluate the endoscopic procedures that were carried out to treat the biliary complications, their success rates, and which protocol should be use in such problem.
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