Cholangiography After Orthotopic Liver Transplantation

Biliary tract complications are still the major cause of morbidity following orthotopic liver transplantation. This book deals systematically with the large variety of possible cholangiographic changes. The figures are the results of a review of cholangiograms from more than 280 patients who underwent orthotopic liver transplantation. The etiology, clinical aspects, and treatment of these complications are reviewed on the basis of the authors' experience in radiology, endoscopy, and transplant surgery.

Introduction: Biliary Reconstruction and Biliary Complications; Normal Cholangiograms Following Orthotic Liver Transplantation.- Short Overview.- Case 1 Normal Postoperative Cholangiogram Following OLT.- Case 2 Normal Postoperative Cholangiogram with a Certain Degree of Mismatch Between Common Bile Ducts of Donor and Receipt.- Case 3 Regular Postoperative Anastomosis of the Common Bile Duct of Donor and Recipient.- Case 4 Normal Cholangiogram After Transplantation of a Reduced-Size Liver Graft.- Biliary Leakage.- Short Overview.- Case 5 Biliary Leakage After Displacement of a Drange Catheter and Endoscopic Treatment with Endoprostheses.- Case 6 Biliary Leakage and Retention of Part of a Disrupted T-Tube; Situation After Endoscropic Removal and Surgical Repair.- Early Tertiary ’lemuroids’.- Case 7 Biliary Leakage at the Site of Bile Duct Anastomosis.- Case 8 Biliary Leakage and Stenosis at the Site of Bile Duct Anastomosis.- Bile Duct Redundancy.- Short Overview.- Case 9 Bile Duct Redundancy with Unimpaired Bile Flow.- Case 10 Bile Duct Redundancy with Impaired Bile Flow and Subsequent Bacterial Cholangitis; Treatment by insertion of Metal Stent.- Sludge in the Biliary System.- Short Overview.- Case 11 Sludge in the Biliary System and Treatment by Balloon Extraction After Sphincterotomy.- Stenosis at the Site of Bile Duct Anastomosis.- Short Overview.- Case 12 Stenosis at the Site of Bile Duct Anastomosis; Endoscopic Treatment by Dilation and Placement of a Metal Stent.- Case 13 Stenosis at Bile Duct Anastomosis; Treatment by Endoscopic Dilation.- Case 14 Stenosis at the Site of Bile Duct Anastomosis; Endoscopic Treatment by Dilation and Preliminary Insertion of a Plastic Endoprosthesis.- Bile Duct Stenosis Due to Local Ischemia.- Short Overview.- Case 15 Necrosis of the Common Bile Duct and Alteration of the Intrapatic Ducts.- Case 16 Sequelae of Ischemia of the Common Bile Duct of Grafted Liver.- Stenoses of All Major Bile Ducts Following Ischemia.- Function of primate dentitions.- Ischemic-Type Lesions Following Long Cold Ischemia.- Short Overview.- Case 19 Alterations of the Intra- and Extrahepatic Biliary System After OLT; Follow-Up Studies.- Case 20 Severe Alterations of the Intra- and Extrahepatic Biliary System; Endoscopic Treatment and Follow-Up Films.- Case 21 Progressive Sequelae from Prolonged Cold Ischemia.- Case 22 Course of Ischemic-Type Biliary Lesions.- Bile Duct Alterations After Occlusion of Hepatic Artery.- Short Overview.- Case 23 T-Tube Cholangiogram After Occlusion of the Hepatic Artery.- Case 24 T-Tube Cholangiogram After OLT and Cholangiogram After Occlusion of the Hepatic Artery.- Case 25 Cholangiogram After Occlusion of the Hepatic Artery.- Case 26 Cholangiogram After Arterial Malperfusion, Stenosis of the Hepatic Artery, Progression of Bile Duct Alterations, and Precutaneous Treatment; Results of Therapy.- Bile Ducts in Chronic Rejection.- Short Overview.- Case 27 Cholangiogram from a Patient with Chronic Rejection of the Graft.- Case 28 Initial Alterations of the Hepatic Biliary System in Chronic Rejection; Progression on Follow-Up.- Case 29 Course of Alterations of the Biliary System in Chronic Rejection.- Disturbed Function of the Sphincter of Oddi.- Short Overview.- Case 30 Stone in the Recipients’s Dilated Common Bile Duct.- Case 31 Dilated Common Duct in the Recipient and Stenoses of the Main Hepatic Ducts.- References.