Clinical characteristic and effect of biliary stricture following orthotopic liver transplantation(report of 60 eases)

Objective To summarize the clinical manifestation of biliary strictures (BS) in patients after orthotopic liver transplantation (OLT), and to investigate the approach and effect of endoscopic retrograde cholangiography (ERCP) for BS after OLT. Methods The clinical manifestation, findings, therapies and efficacy of 60 patients with BS after OLT were retrospectively analyzed. Results Patients showed symptoms such as jaundice and fever. The average treatment time was (195.5±146.5) days after operation. In the early of BS, liver damage for serum alanine aminotransferase, total bilirubin, glutamyltranspeptidase enzymes and alkaline phosphatase were elevated, and albumin lowered. In the late stage of BS, the level of alanine aminotransferase was decreased and the "gall-separation" occurred. ERCP examination showed there were 6 cases of simple anastomotic stricture, 11 cases of hitar and/or in combination with anastomotie stricture, 1 t cases of diffuse intrahepatic bile duct stenosis, 32 cases of anastomotic stricture combined with intrahepatic bile duct diffuse/segmental stenosis. Other complications included foreign bodies in bile duct, dilation proximal to the stricture, bile duct distort, JPD etc. By ERCP treatment, 33 patients were cured, 18 cases improved, and remaining 9 failed to the treatment. Conclusions After liver transplantation, the incidence of bile duct stricture and complications is high. The bile duct after liver transplantation can be definitely diagnosed and satisfactorily treated by ERCP. Key words: Liver transplantation; Bile ducts; Cholangiopancreatography, endoscopic retrograde