Background: Biliary tract complications are the most common complications after liver transplantation and it remains a major source of morbidity in liver transplant patients. Non-operative treatment is often successful in early complications. Late complications presenting with leaks and obstruction are often more difficult to treat non-operatively and frequently require surgical treatment or re-transplantation. Some centers are more aggressive with management of biliary strictures and prefer early surgical intervention as opposed to multiple endoscopic dilations.
Aim of the work: The aim of this study is to, discuss the surgical management of post-transplant biliary complications and its outcome and rate of success with or without previous non-surgical methods in the postoperative follow up.
Patients and methods: This is a combined prospective and retrospective study conducted in DAR EL FOAD hospital, liver transplantation unitduring the period from 2011 till 2020. it included patient with post-transplant biliary complications who underwent surgical intervention with and without prior conservative trials. the study contains 14 patients who had failed non operative management. We discussed the surgical management and its outcome.
Results: 380 patients underwent liver transplantation during this period. 45 had biliary complications, of them 31 patients were managed by non-surgical measures and those were excluded from our study. 14 patients underwent surgical intervention. we had 4 patients with stricture, 7 patients with leakage and 3 patients with stricture and leakage. two patient had recurrent biliary complications after surgery and there was only one mortality.
Conclusion: Non-surgical measures are the primary treatment option for post transplantation biliary complications, but surgical management is the definite management for refractory cases with less hospital stay and recurrent admissions.