Background: Biliary complications develop in 10-40 % of patients following liver transplantation. Biliary strictures, leaks, and stone are the most common type of complications. In this study, we focused on the endoscopic treatment of biliary stones.
Methods: Among 142 patients with liver transplantation [22 deceased donor related (DDLT), 120 live donor related liver transplantation (LDLT)] who underwent endoscopic retrograde cholangiopancreatography (ERCP) between December 2013 and September 2015, 33 (11 with DDLT, 28 male, mean age 45 ± 13 years) had one or more biliary stones. ERCP was performed through papilla in all of the patients other than a patient with hepaticojejunostomy.
Results: Biliary stones were extracted in all 6 patients without anastomosis stricture (AS), 3 of 6 (50 %) patients with DDLT and AS, in 13 of 16 (81.5 %) patients with LDLT and AS, and in 3 of 5 (60 %) patients with non-anastomosis stricture (NAS). The total number of sessions required for the extraction of stones was less in patients with biliary stones without AS [1.5 (1-2)] compared to those with AS and DDLT [2 (1-6)] or LDLT [3 (1-5)]. Patients with NAS (n = 5) required a greater number of sessions [7 (1-10)].
Conclusions: Stone extraction is difficult in patients with NAS and requires a greater number of ERCP sessions. The treatment of biliary stones proximal to an AS in patients with DDLT or LRLT is possible in most cases.
Keywords: Biliary complication; Biliary stone; Endoscopic retrograde cholangiopancreatography (ERCP); Liver transplantation.