Radiological Interventions in Post-transplant Biliary Strictures

By  Dr. Deepashree T

Radiological Interventions in Post-transplant Biliary Strictures

Post-transplant biliary strictures are a known complication after liver transplantation. Following a liver transplant, they occur when there is a narrowing or obstruction in the bile ducts that connect the liver to the small intestine (common bile duct and its branches). These strictures can lead to bile flow impairment, causing symptoms such as jaundice, itching and cholangitis (infection of the bile ducts).

Few tips to avoid this complication are avoiding this complication are: RHD not to be clamped to avoid crushing injury back table. Graft to be flushed with the University of Wisconsin or histidine-tryptophan-ketoglutarate solution. A small amount of liver tissue should be left around the right hepatic duct to prevent devascularization, and the complete right hilar plate should be encircled.

Also, it has been seen that preventing bile leaks has the potential to reduce the incidence of biliary strictures, apart from the reduction in biliary and fungal sepsis. Using the bile leak test with saline, propofol or intralipid can be beneficial in reducing strictures and sepsis, particularly in the early stage of a program or when biliary reconstruction is complicated.

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Dr. Deepashree T

Dr. Deepashree T is an Senior Consultant in Interventional Radiology and Imaging Services. She has completed her MBBS 2000, Dr.NTR University of Health Sciences, India, MRCP 2005, Royal College of Physicians, London, UK, FRCR 2010, Royal College of Radiologists, EBIR (European Board of Interventional Radiology) 2012, College PG Cert 2008, Health Research, University of Leeds CCT 2012, General Medical Council, UK.

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