Journal of Liver: Krankheit und Transplantation

Current Safety and Feasibility of ERCP in Management of Early and Late Post Liver Transplant Biliary Complications

Esam Elshimi, Ashraf Eljaky, Ahmed Attia, Helmy Elshazly and Gamal Badra

Abstract

Background: Biliary complications after living donor liver transplantation (LDLT) represent the most challengeable burden.
Aim: Safety, feasibility, clinical and biochemical changes before and after treatment of biliary complications after LDLT. Patients & Methods: This was retrospective study: between April 2014 and December 2015, we reviewed medical records of 108 patients with LDLL. ERCP was indicated in 30 patients (28 males) at the National Liver Institute.
Results: Stricture was the highest reported (56.7%) >leakage (53.3%) >dilatation of CBD (SOD), and cholangitis (3.3%). Post ERCP complication: pancreatitis and bleeding in one case for each. The frequencies of complication in every patient were: 1, 2 & 3 complications in 21, 7 & 2 respectively. Timing of complications: in ≤ 3 months 16 patients, 22 patients in 4-12 month, 3 patients>1 year. Post ERCP complications: mild pancreatitis and GIT bleeding in one patient for each, there were significant changes regarding all liver profile after LDLT before any complication and on the day of presentation (during complication) and between the last one and Follow up (one month) after ERCP (p<0.05).
Conclusion: ERCP was safe and effective in treatment of post liver transplant biliary complications.