Percutaneous management of anastomotic bile leaks following liver transplantation.

PURPOSE: To review our experience with percutaneous internal-external biliary drainage in treating biliary anastomotic leaks following orthotopic liver transplantation.

MATERIALS AND

METHODS

Between September 1997 and June 2006, 157 liver transplantations were performed in our hospital. Percutaneous transhepatic biliary drainage was performed in 10 patients (9 males, 1 female; mean age, 32.9 years; age range, 2-62 years) with patent hepatic arterial systems to treat clinically significant anastomotic bile leaks.

RESULTS

Bile leaks were resolved and anastomotic patency was restored in all patients. Massive hemobilia occurred in 1 patient due to arterial pseudoaneurysm and was treated with embolization. No major complications were seen in the other patients. During a mean follow-up of 19.5 months, anastomotic stricture occurred in 2 patients (1 in combination with a recurrent leak). Both patients were successfully treated with percutaneous methods. The remaining 8 patients had no biliary problems.

CONCLUSION

When treating anastomotic bile leaks in liver transplant patients, percutaneous procedures may be performed with high technical success and low complication rates.