Biliary complications after liver transplantation: current perspectives and future strategies
| العنوان: | Biliary complications after liver transplantation: current perspectives and future strategies |
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| المؤلفون: | Matteo Tacelli, Filomena Conti, Alessandra Mazzola, Ciro Celsa, Bianca Magro |
| المساهمون: | Magro, Bianca, Tacelli, Matteo, Mazzola, Alessandra, Conti, Filomena, Celsa, Ciro |
| المصدر: | Hepatobiliary Surgery and Nutrition. 10:76-92 |
| بيانات النشر: | AME Publishing Company, 2021. |
| سنة النشر: | 2021 |
| مصطلحات موضوعية: | medicine.medical_specialty, Endoscopic retrograde cholangiopancreatography, Percutaneous, medicine.diagnostic_test, Bile duct, business.industry, Liver transplantation (LT), biliary tract diseases, cholangiography, cholangiopancreatography endoscopic retrograde, review, medicine.medical_treatment, 030230 surgery, Liver transplantation, medicine.disease, Surgery, Transplantation, 03 medical and health sciences, Liver disease, 0302 clinical medicine, medicine.anatomical_structure, Cholangiography, medicine, Etiology, 030211 gastroenterology & hepatology, business |
| الوصف: | Importance: Liver transplantation (LT) is a life-saving therapy for patients with end-stage liver disease and with acute liver failure, and it is associated with excellent outcomes and survival rates at 1 and 5 years. The incidence of biliary complications (BCs) after LT is reported to range from 5% to 20%, most of them occurring in the first three months, although they can occur also several years after transplantation.Objective: The aim of this review is to summarize the available evidences on pathophysiology, risk factors, diagnosis and therapeutic management of BCs after LT.Evidence Review: a literature review was performed of papers on this topic focusing on risk factors, classifications, diagnosis and treatmentFindings: Principal risk factors include surgical techniques and donor's characteristics for biliary leakage and anastomotic biliary strictures and vascular alterations for nonanastomotic biliary strictures. MRCP is the gold standard both for intra- and extrahepatic BCs, while invasive cholangiography should be restricted for therapeutic uses or when MRCP is equivocal. About treatment, endoscopic techniques are the first line of treatment with success rates of 70-100%. The combined success rate of ERCP and PTBD overcome 90% of cases. Biliary leaks often resolve spontaneously, or with the positioning of a stent in ERCP for major bile leaksConclusions and Relevance: BCs influence morbidity and mortality after LT, therefore further evidences are needed to identify novel possible risk factors, to understand if an immunological status that could lead to their development exists and to compare the effectiveness of innovative surgical and machine perfusion techniques. |
| تدمد: | 2304-389X 2304-3881 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::1e2ad3a8ed5c60fcc9b642400586750fTest https://doi.org/10.21037/hbsn.2019.09.01Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....1e2ad3a8ed5c60fcc9b642400586750f |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 2304389X 23043881 |
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