Hilar biliary strictures after liver transplantation: Cholangiography and percutaneous treatment

Ellen M. Ward, Michael J. Kiely, Timothy P. Maus, Russell H. Wiesner, Ruud A.F. Krom

Research output: Contribution to journalArticlepeer-review

117 Scopus citations

Abstract

Nonanastomotic hilar bile duct strictures developed in 16 of 152 patients who underwent liver transplantation. The type of pretransplantation liver disease did not significantly affect the likelihood of hilar stricture formation. Possible causes of hilar biliary strictures include hepatic artery occlusion, ductopenic arteriopathic rejection, and cytomegalovirus infection; however, five of the 16 patients had hilar strictures without these complications. Hilar strictures developed within 3 months after transplantation in 11 of the 16 patients. Strictures began as a slight common hepatic duct irregularity and progressed to mucosal cast formation and later to firm strictures. Fifteen of the 16 patients underwent percutaneous stricture dilation. Of 12 patients who no longer have stents, four have had no stricture recurrence for 12-30 months. Eight patients have had to undergo retransplantation or have died. Percutaneous dilations were most likely to result in patent bile ducts if strictures developed within 3 months after transplantation and in the absence of pretransplantation primary sclerosing cholangitis, ductopenic arteriopathic rejection, cytomegalovirus infection, or hepatic artery thrombosis.

Original languageEnglish (US)
Pages (from-to)259-263
Number of pages5
JournalRadiology
Volume177
Issue number1
DOIs
StatePublished - Oct 1990

Keywords

  • Bile ducts, interventional procedure, 768.1229
  • Bile ducts, stenosis or obstruction, 768.289
  • Liver, interventional procedure, 761.1229
  • Liver, transplantation, 761.458

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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