Successful treatment of complex cholangiolithiasis following orthotopic liver transplantation with interventional radiology

World J Gastroenterol. 2015 Feb 14;21(6):2000-4. doi: 10.3748/wjg.v21.i6.2000.

Abstract

Bile duct stones are a serious and the third most common complication of the biliary system that can occur following liver transplantation. The incidence rate of bile duct stones after liver transplantation is 1.8%-18%. The management of biliary stones is usually performed with endoscopic techniques; however, the technique may prove to be challenging in the treatment of the intrahepatic bile duct stones. We herein report a case of a 40-year-old man with rare, complex bile duct stones that were successfully eliminated with percutaneous interventional techniques. The complex bile duct stones were defined as a large number of bile stones filling the intra- and extrahepatic bile tracts, resulting in a cast formation within the biliary tree. Common complications such as hemobilia and acute pancreatitis were not present during the perioperative period. The follow-up period was 20 mo long. During the postoperative period, the patient maintained normal temperature, and normal total bilirubin and direct bilirubin levels. The patient is now living a high quality life. This case report highlights the safety and efficacy of the percutaneous interventional approach in the removal of complex bile duct stones following liver transplantation.

Keywords: Complex bile duct stones; Extrahepatic bile tract; Intrahepatic bile tract; Liver transplantation; Percutaneous interventional technique.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Catheterization / instrumentation
  • Catheterization / methods*
  • Catheters
  • Cholangiopancreatography, Magnetic Resonance
  • Cholelithiasis / diagnosis
  • Cholelithiasis / etiology
  • Cholelithiasis / therapy*
  • Drainage / instrumentation
  • Drainage / methods*
  • Equipment Design
  • Humans
  • Liver Transplantation / adverse effects*
  • Male
  • Radiography, Interventional / instrumentation
  • Radiography, Interventional / methods*
  • Sphincterotomy, Transduodenal
  • Treatment Outcome