Year 2019 / Volume 111 / Number 12
Original
Endoscopic retrograde cholangiopancreatography in the management of biliary complications after orthotopic liver transplantation

909-913

DOI: 10.17235/reed.2019.6284/2019

Juan Egea Valenzuela, Roxanna Jijón Crespín, Andrés Serrano Jiménez, Fernando Alberca de las Parras,

Abstract
Background: biliary complications are frequent after orthotopic liver transplantation and the management of these complications with endoscopic retrograde cholangiopancreatography (ERCP) is available. The aims of the study were to analyze the experience in the endoscopic management of biliary complications after liver transplantation in a third level center. Furthermore, the factors associated with higher rates of technical and clinical success were determined. Methods: this was an observational retrospective study of ERCPs performed in patients with biliary complications after liver transplantation between February 2012 and January 2017. The factors analyzed were: demographics, time between transplantation and ERCP, indications for ERCP, strategy of stenting (only plastic stents, only self-expandable metallic stents, plastic followed by metallic stents and metallic followed by plastic stents), technical and clinical success and complications. Results: one hundred and sixty-eight endoscopies were performed in 58 patients. Thirty-three patients (56.9%) presented with early complications. The most frequent indication for ERCP was anastomotic stenosis (57.8%). Technical success in the first ERCP was achieved in 43 patients (74.1%). Early onset of biliary complications was associated with higher rates of technical success (OR: 6.49; p: 0.036). Clinical success was obtained in 36 cases (62.1%). Patients with early complications had a higher probability of having good clinical response (OR: 11.16; p: 0.033). The results were worse in patients with only plastic stents (50% of clinical success). Eleven complications were observed among 168 ERCPs (6.54%), including two pancreatitis, five bleeding events, three cholangitis and one micro-perforation. Conclusions: ERCP is safe and useful in the management of biliary complications after liver transplantation. Early onset of complications is associated with better results. Some patients will need repeated procedures to obtain a good clinical response.
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Egea Valenzuela J, Jijón Crespín R, Serrano Jiménez A, Alberca de las Parras F. Endoscopic retrograde cholangiopancreatography in the management of biliary complications after orthotopic liver transplantation. 6284/2019


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Publication history

Received: 16/03/2019

Accepted: 29/05/2019

Online First: 21/10/2019

Published: 05/12/2019

Article revision time: 64 days

Article Online First time: 219 days

Article editing time: 264 days


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