Exp Clin Transplant. 2017 Apr 14; doi: 10.6002/ect.2017.0023. Epub 2017 Apr 14.
Incidence and Treatment of Bile Stones After Liver Transplant.
Experimental and clinical transplantation : official journal of the Middle East Society for Organ Transplantation
Mahir Kırnap, Ebru Hative Ayvazoğlu Soy, Aydıncan Akdur, Sedat Yıldırım, Ali Harman, Gökhan Moray, Mehmet Haberal
Affiliations
Affiliations
- Department of General Surgery, Ba?kent University, Faculty of Medicine, Ankara, Turkey.
PMID: 28411359
DOI: 10.6002/ect.2017.0023
Abstract
OBJECTIVES: Although the incidence of bile stones after liver transplant is rare (2%-6%), various complications can occur, including recurrent cholangitis, biliary strictures, graft loss, and patient mortality.
MATERIALS AND METHODS: We retrospectively evaluated bile stone incidence, pathogenesis, and treatment in 352 liver transplant recipients, comparing demographics, transplant indication, blood lipid profile, bile reconstruction technique, postoperative complications, time of diagnosis, and treatment regimens.
RESULTS: Of 352 recipients, 18 had bile stones, with 13 of these patients (72.2%) receiving duct-to-duct bile reconstruction, 17 having biliary complications before bile stone development, 7 (38.9%) having biliary stricture, 6 (33.3%) having biliary leakage, 4 (22.2%) having biliary strictures secondary to biliary leakage, and 7 (38.9%) having hepatic artery complications early posttransplant. Previous biliary complications and recurrent cholangitis significantly increased bile stones. Incidence in patients with triglyceride levels > 250 mg/dL was significantly different from those with levels at < 250 mg/dL. Cold ischemia time was significant in those with and without bile stones (P = .001). Three patients (16%) were treated by endoscopic tools, with others (15/18, 84%) treated via percutaneous procedures.
CONCLUSIONS: Bile stone risk can be greater in those with previous biliary complications, hepatic artery problems, long cold ischemia time, and high cholesterol levels. It can be successfully treated by endoscopic and percutaneous techniques.
Publication Types
