Cholangiopathien nach Lebertransplantation

Biliary complications occur in up to 30% of liver transplantations. Bile leaks can be treated successfully by transient endoscopic stenting. A severe complication is hepatic artery thrombosis, which can often lead to bile duct necrosis with consecutive liver abscess and sepsis. Bile duct strictures can occur at the anastomosis (anastomotic strictures – AS) or at the hilar and/or intrahepatic levels as ischemic type biliary lesions (ITBL). AS can be treated successfully with a combination of balloon dilatation and insertion of endoprostheses. In ITBL available data is more ambiguous, but repeated balloon dilatation seems to be successful and can at least considerably delay mandatory retransplantation. First results show that the challenging anastomotic strictures after living donor liver transplantation can be treated endoscopically with considerable success.