Copyright ©2008 The WJG Press and Baishideng.
World J Gastroenterol. Jan 28, 2008; 14(4): 493-497
Published online Jan 28, 2008. doi: 10.3748/wjg.14.493
Table 1 Risk factors for the development of biliary complications after OLT
1 T-tube
2 Roux-en-Y anastomosis
3 Ischemia/Reperfusion injury
4 Acute hepatic artery thrombosis
5 Infections
6 ABO mismatch
7 Non-heart beating donors
8 Primary sclerosis cholangitis
Table 2 Key points in the management of bile duct strictures
- Bile duct strictures can be classified as anastomotic or non-anastomotic
- Early anastomotic strictures usually respond to endoscopic dilation and short-term stenting
- Late anastomotic strictures have a high rate of recurrence (30%-40%) requiring long-term stenting (up to 24 mo).
- If endoscopic or percutaneous treatment fails, surgical repair or conversion to Roux-en-Y choledochojejunostomy may be necessary
- Non-anastomotic strictures require long-term stenting
- Some patients do not respond and finally undergo re-transplantation or die because of this complication