Percutaneous management of anastomotic bile leaks following liver transplantation

Abstract

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.