Learning objectives
Explain and illustrate by images of patients at our institution the imaging findings of biliary complications after liver transplantation.
Background
Currently,
liver transplantation is the first line treatment for patients with liver terminal disease,
both acute and chronic.
However,
postoperative complications may limit the success of the intervention,
because of their mortality and morbidity.
There are different types of complications of liver transplantation.
In the current work,
biliary complications will be explained.
They occur on about 25% of liver transplants.
Early diagnosis is very important because it directly conditions the subsequent evolution of the patient.
Most complications develop in the first three months after transplantation....
Findings and procedure details
The surgical technique most conventionally used is choledocus-choledochotomy.
Kher tube is placed to protect the bile duct from strictures and tears and allow easy access for cholangiography.
Tube is removed after some time.
In our center,
this time is three months.
In recent years a new technique has been introduced: hepaticojejunostomy on defunctionalized loop.
Complications that affect the bile duct have a very high prevalence: they occur approximately on 25% of liver transplant recipients,
are more frequent in the first three months after transplantation.
Furthermore,...
Conclusion
Biliary complications are a common cause of liver transplantation malfunction.
Its initial diagnosis is performed with ultrasound examination,
although in many cases it is necessary to complement the study through CT scan or interventional procedures.
Early diagnosis of these alterations of the graft is critical to ensure that it works fine and to reduce the morbidity and mortality of the patients.
References
1.- Bhargava P,
Vaidya S,
Dick A,
Dighe M.
Imaging of Orthotopic Liver Transplantation: Review.
American Journal of Roentgenology 2011;196:WS15–25.
doi:10.2214/AJR.09.7221.
2.- Caiado A,
Blasbalg R,
Marcelino A,
da Cunha Pinho M,
Chammas M,
da Costa Leite C,
et al.
Complications of Liver Transplantation: Multimodality Imaging Approach.
RadioGraphics 2007;27:1401–17.
doi:10.1148/rg.275065129.
3.- Singh A,
Nachiappan A,
Verma H,
Uppot R,
Blake M,
Saini S,
et al.
Postoperative Imaging in Liver Transplantation: What Radiologists Should Know.
RadioGraphics 2010;30:339–51.
doi:10.1148/rg.302095124.