Cystic Duct Bile Leak in Graft: An Unexpected Origin for Choleperitoneum After Liver Transplant.
Exp Clin Transplant
; 18(5): 638-640, 2020 10.
Article
em En
| MEDLINE
| ID: mdl-31580232
ABSTRACT
From the beginning of liver transplant implementation, biliary anastomosis has been considered its weakness. An anastomotic bile leak is the most frequent cause of bile in the peritoneum (choleperitoneum) after liver transplant but not the only one. Here, we report a 58-year-old man with hepatitis C virus-related cirrhosis who had orthotopic liver transplant due to presence of hepatocellular carcinoma.During the immediate postoperative period, bile leakwas diagnosed on trans-Kehr cholangiography. Contrast extravasation was observed on the graft's cystic duct, and no contrast flow into the native biliary tract was demonstrated. Surgical intervention was required after endoscopic management failure. Bile leak through the cystic duct was repaired, and a Rouxen-Y bilioenteric diversion was performed. Biliary complications can significantly increase morbidity and mortality after liver transplant. Anastomotic bile leaks are the most frequent; however, other locations must not be dismissed as possible origins of leak. It is mandatory to consider underlying hepatic artery complications as thrombosis or stenosis. Treatment will depend on the leak origin, which are most times accessible to endoscopic retrograde cholangiopancreatography. However, other locations and the different treatment options must also be considered. It is also necessary not to forget the influence of bile leaks on biliary stenosis development in the long term and its contribution to increased patient morbidity and mortality.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Peritônio
/
Ácidos e Sais Biliares
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Procedimentos Cirúrgicos do Sistema Biliar
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Transplante de Fígado
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Carcinoma Hepatocelular
/
Ducto Cístico
/
Fístula Anastomótica
/
Neoplasias Hepáticas
Tipo de estudo:
Diagnostic_studies
Limite:
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Exp Clin Transplant
Ano de publicação:
2020
Tipo de documento:
Article