transplantologiyaТрансплантологияTransplantologiya. The Russian Journal of Transplantation2074-05062542-0909IPO Association of Transplantologists10.23873/2074-0506-2009-0-2-44-50transplantologiya-254Research ArticleОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯORIGINAL INVESTIGATIONSБилиарные осложнения после ортотопической трансплантации печениBiliary complications after orthotopic liver transplantationОлисовО. Д.OlisovO. D.

Олег Даниелович Олисов

oleg-doc@yandex.ruНИИ скорой помощи им. Н.В. СклифосовскогоРоссияN.V. Sklifosovsky Research Institute of Emergency CareRussian Federation200916082018024450Copyright © Олисов О.Д., 20182018Олисов О.Д.Olisov O.D.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.jtransplantologiya.ru/jour/article/view/254

Посттрансплантационные билиарные осложнения — серьезная проблема после ортотопической трансплантации печени. Благодаря развитию хирургической техники частота билиарных осложнений за 40 лет истории трансплантации печени снизилась в несколько раз, но до сих пор достигает 10—35%, индуцируя 2—9,6% летальность. В обзоре излагается классификация билиарных осложнений, определяются факторы риска их развития, возможность профилактики и варианты коррекции.

Orthotopic liver posttransplantation biliary complications are a serious problem. Due to the development of surgical techniques, the incidence of biliary complications has decreased by several times over the 40-year history of liver transplantation, but achieved 10-35% up to the present, by inducing 2-9.6% mortality. The review presents a classification of biliary complications, defines risk factors of their development, a possibility of their prevention, and correction options.

ортотопическая трансплантация печениосложнения послеоперационныебилиарные осложненияorthotopic liver transplantationpostoperative complicationsbiliary complicationsReferencesTing-Bo Liang. Billiary tract complication after liver transplantation. Hepatobiliary Pancreat Dis Int 2005;4(1):10—1.Ting-Bo Liang. Billiary tract complication after liver transplantation. Hepatobiliary Pancreat Dis Int 2005;4(1):10—1.Neuhaus P. Technique and results of biliare reconstruction using side-to side choledochocholedochostomy in 300 orthotopic liver transplantation. Ann Surg 1994;219(4):426—34.Neuhaus P. Technique and results of biliare reconstruction using side-to side choledochocholedochostomy in 300 orthotopic liver transplantation. Ann Surg 1994;219(4):426—34.Busuttil R.W., Farmer D.G., Yersiz H. et al. Analysis of long-term outcomes of 3200 liver transplantations over two decades a single-center experience. Ann Surg 2005;241(6):905—18.Busuttil R.W., Farmer D.G., Yersiz H. et al. Analysis of long-term outcomes of 3200 liver transplantations over two decades a single-center experience. Ann Surg 2005;241(6):905—18.Jia-Zhi Liao, Qui Zhao, Hua Qin et al. Endoscopic diagnosis and treatment of biliary leak in patients following liver transplantation: a prospective clinical study. J Hepatobiliary Pancreat Dis Int 2007;6:29—3.Jia-Zhi Liao, Qui Zhao, Hua Qin et al. Endoscopic diagnosis and treatment of biliary leak in patients following liver transplantation: a prospective clinical study. J Hepatobiliary Pancreat Dis Int 2007;6:29—3.Takatsuki M., Eguchi S., KawashitaY., Kanematsu T. Biliary complications in recipients of living-donor liver transplantation. J Hepatobiliary Pancreat Surg 2006;13: 497—501.Takatsuki M., Eguchi S., KawashitaY., Kanematsu T. Biliary complications in recipients of living-donor liver transplantation. J Hepatobiliary Pancreat Surg 2006;13: 497—501.Moser M.A.J., Wall W.J. Management of biliary problems after liver transplantation. Liver Transplantat 2001;7(11 suppl 1):46—52.Moser M.A.J., Wall W.J. Management of biliary problems after liver transplantation. Liver Transplantat 2001;7(11 suppl 1):46—52.Fleck A. Jr., Zanotelli M.L., Meine M. et al. Billiary tract complication after orthotopic liver transplantation in adult patients. Transplantat Proceedings 2002;34:519—20.Fleck A. Jr., Zanotelli M.L., Meine M. et al. Billiary tract complication after orthotopic liver transplantation in adult patients. Transplantat Proceedings 2002;34:519—20.Grief F., Bronsther O., Van Theil D. et al. The inciedence, timing, and managment of biliary tract complication after orthotopic liver transplantation. Ann Surg 1994;219(1):40—5.Grief F., Bronsther O., Van Theil D. et al. The inciedence, timing, and managment of biliary tract complication after orthotopic liver transplantation. Ann Surg 1994;219(1):40—5.Brering D.C., Walter J., Braun F., Rogiers X. Current status of hepatic transplantation. Curr Probl Surrg 2008;45:618.Brering D.C., Walter J., Braun F., Rogiers X. Current status of hepatic transplantation. Curr Probl Surrg 2008;45:618.Leonardi L.S., Boin I.F., Neto F.C. et al. Biliary reconstructions in 150 orthotopic liver transplantations: an experience with three techniques. Transplantat Proceedings 2002;34:1211—5.Leonardi L.S., Boin I.F., Neto F.C. et al. Biliary reconstructions in 150 orthotopic liver transplantations: an experience with three techniques. Transplantat Proceedings 2002;34:1211—5.Pascher A., Neuhaus P. Biliary complications after deceased-donor orthotopic liver transplantation. J Hepatobiliary Pancreat Surg 2006;13:487—96.Pascher A., Neuhaus P. Biliary complications after deceased-donor orthotopic liver transplantation. J Hepatobiliary Pancreat Surg 2006;13:487—96.Wojcickia M., Milkiewicz P., Silva M. Biliary tract complications after liver transplantation: a review. Dig Surg 2008;25: 245—57.Wojcickia M., Milkiewicz P., Silva M. Biliary tract complications after liver transplantation: a review. Dig Surg 2008;25: 245—57.Golling M., Von Frankenberg M., Ioannidis P. et al. Impact of billiary reconstruction on postoperative complications and reintervnsions in 179 liver transplantations. Transplantat Proceedings 1998;30:3180—1.Golling M., Von Frankenberg M., Ioannidis P. et al. Impact of billiary reconstruction on postoperative complications and reintervnsions in 179 liver transplantations. Transplantat Proceedings 1998;30:3180—1.Jagannath S., Kalloo A.N. Biliary complications after liver transplantation. Curr Treatm Options Gastroenterol 2002;5: 101—12.Jagannath S., Kalloo A.N. Biliary complications after liver transplantation. Curr Treatm Options Gastroenterol 2002;5: 101—12.Ye Ben Qian, Chi Leung Liu, Chung Mau Lo, Sheung Tat Fan. Risk factors for biliary complications after liver transplantation. Arch Surg 2004;139:1101—5.Ye Ben Qian, Chi Leung Liu, Chung Mau Lo, Sheung Tat Fan. Risk factors for biliary complications after liver transplantation. Arch Surg 2004;139:1101—5.Fenella K.S., Wigmore S. J. Roux-en-Y choledochojejunostomy is the method of choice for billiary reconstruction in liver transplantation for primary sclerosing cholangitis. Transplantation 2004;77(34):602—4.Fenella K.S., Wigmore S. J. Roux-en-Y choledochojejunostomy is the method of choice for billiary reconstruction in liver transplantation for primary sclerosing cholangitis. Transplantation 2004;77(34):602—4.Pomposelli J.J., Jenkins R.L. Early and late complication of liver transplantation. In: L.H. Blumgart, ed. Surgery of the liver, biliary tract and pancreas. 4th ed. Philadelpia: Saunders Elseiver, 2007. vol. 2. p. 1801—2.Pomposelli J.J., Jenkins R.L. Early and late complication of liver transplantation. In: L.H. Blumgart, ed. Surgery of the liver, biliary tract and pancreas. 4th ed. Philadelpia: Saunders Elseiver, 2007. vol. 2. p. 1801—2.Sharma S., Gurakar A., Jabbour N., Zuhdi N. Biliary strictures following liver transplantation: past, present and preventive strategies. Transplantation 2008;14:759—69.Sharma S., Gurakar A., Jabbour N., Zuhdi N. Biliary strictures following liver transplantation: past, present and preventive strategies. Transplantation 2008;14:759—69.Helton T.G., Smallwood G.A., Ramcharan T. et al. Duct-to-duct biliary anastomosis for patient with sclerosing cholangitis undergoing liver transplantation. Transplantat Proceedings 2003;35:3006—7.Helton T.G., Smallwood G.A., Ramcharan T. et al. Duct-to-duct biliary anastomosis for patient with sclerosing cholangitis undergoing liver transplantation. Transplantat Proceedings 2003;35:3006—7.Campbell W.L., Sheng R., Zajko A.B. et al. Intrahepatic biliary strictures after liver transplantation. Radiology 1994;191:735—40.Campbell W.L., Sheng R., Zajko A.B. et al. Intrahepatic biliary strictures after liver transplantation. Radiology 1994;191:735—40.Verdonk R.C., Buis C.I., van der Jagt E.J. Nonanastomotic biliary strictures after liver transplantation, part 2: management, outcome, and risk factors for disease progression. Liver Transplantat 2007;13:725—32.Verdonk R.C., Buis C.I., van der Jagt E.J. Nonanastomotic biliary strictures after liver transplantation, part 2: management, outcome, and risk factors for disease progression. Liver Transplantat 2007;13:725—32.Abt P., Crawford M., Desai N. et al. Liver transplantation from controlled nonheart-beating donors: an increased incidence of biliary complications. Transplantation 2003;75:1659—63.Abt P., Crawford M., Desai N. et al. Liver transplantation from controlled nonheart-beating donors: an increased incidence of biliary complications. Transplantation 2003;75:1659—63.Cameron A., Busuttil R.W. Ischemic cholangiopathy after liver transplantation. Hepatobiliary Pancreat Dis Int 2005;4: 495—501.Cameron A., Busuttil R.W. Ischemic cholangiopathy after liver transplantation. Hepatobiliary Pancreat Dis Int 2005;4: 495—501.Foley D.P., Fernandez L.A., Leverson G. et al. Donation after cardiac death: the University of Wisconsin experience with liver transplantation. Ann Surg 2005;242:724—31.Foley D.P., Fernandez L.A., Leverson G. et al. Donation after cardiac death: the University of Wisconsin experience with liver transplantation. Ann Surg 2005;242:724—31.Maheshwari A., Maley W., Zhiping Li, Thuluvath P.J. Biliary complications and outcomes of liver transplantation from donors after cardiac death. Liver Transplantat 2007;13:1645—53.Maheshwari A., Maley W., Zhiping Li, Thuluvath P.J. Biliary complications and outcomes of liver transplantation from donors after cardiac death. Liver Transplantat 2007;13:1645—53.Inomata Y., Tanaka K. Pathogenesis and treatment of bille duct loss after liver transplantation. J Hepatobiliary Pancreat Surg 2001;8:316—22.Inomata Y., Tanaka K. Pathogenesis and treatment of bille duct loss after liver transplantation. J Hepatobiliary Pancreat Surg 2001;8:316—22.Moench C., Uhrig A., Lohse A.W., Otto G. CC-chemokine receptor 5Δ 32 polymorphism — a risk factors for ischemic-type billiary lesions following orthotopic liver transplantation. Liver Transplantat 2004;10(3):434—9.Moench C., Uhrig A., Lohse A.W., Otto G. CC-chemokine receptor 5Δ 32 polymorphism — a risk factors for ischemic-type billiary lesions following orthotopic liver transplantation. Liver Transplantat 2004;10(3):434—9.Nakamura N., Nishida S., Neff G.R. et al. Intrahepaticbiliary strictures without hepatic artery thrombosis after liver transplantation: an analysis of 1113 liver transplantation at single center. Transplantation 2005;79(4):427—588.Nakamura N., Nishida S., Neff G.R. et al. Intrahepaticbiliary strictures without hepatic artery thrombosis after liver transplantation: an analysis of 1113 liver transplantation at single center. Transplantation 2005;79(4):427—588.Hintze R.E., Abou-Rebyeh H., Adler A. et al. Endoscopic therapy of ischemic type biliary lesions (ITBL) in patients after orthotopic liver transplantation. Z Gastroenterol 1999;37:13—20.Hintze R.E., Abou-Rebyeh H., Adler A. et al. Endoscopic therapy of ischemic type biliary lesions (ITBL) in patients after orthotopic liver transplantation. Z Gastroenterol 1999;37:13—20.Hae Won Lee, Kyung-Suk Suh, Woo Young Shin. Classiёcation and prognosis of intrahepatic biliary stricture after liver transplantation. Liver Transplant 2007;13:1736—42.Hae Won Lee, Kyung-Suk Suh, Woo Young Shin. Classiёcation and prognosis of intrahepatic biliary stricture after liver transplantation. Liver Transplant 2007;13:1736—42.Buis C.I., Verdonk R.C., Van der Jagt E.J. et al. Nonanastomotic biliary strictures after liver transplantation, Part 1: Radiological features and risk factors for early vs. late presentation. Liver Transplantat 2007;13:708—18.Buis C.I., Verdonk R.C., Van der Jagt E.J. et al. Nonanastomotic biliary strictures after liver transplantation, Part 1: Radiological features and risk factors for early vs. late presentation. Liver Transplantat 2007;13:708—18.Srinivasaiah N., Reddy M.S., Balupuri S. et al. Biliary cast syndrome: literature review and a single centre experience in liver transplant recipients. Hepatobiliary Pancreat Dis Int 2008;7:300—3.Srinivasaiah N., Reddy M.S., Balupuri S. et al. Biliary cast syndrome: literature review and a single centre experience in liver transplant recipients. Hepatobiliary Pancreat Dis Int 2008;7:300—3.Shah J.N., Haigh W.G., Lee S.P. et al. Biliary casts after orthotopic liver transplantation: clinical factors, treatment, biochemical analysis. Am J Gastroenterol 2003;98: 1861—7.Shah J.N., Haigh W.G., Lee S.P. et al. Biliary casts after orthotopic liver transplantation: clinical factors, treatment, biochemical analysis. Am J Gastroenterol 2003;98: 1861—7.Sheng R., Ramirez C.B., Zajko A.B., Campbell W.L. Biliary stones and sludgein liver Transplant Patients : A 13-year Experience. Radiology 1996;198:243—7.Sheng R., Ramirez C.B., Zajko A.B., Campbell W.L. Biliary stones and sludgein liver Transplant Patients : A 13-year Experience. Radiology 1996;198:243—7.Spier B.J., Pfau P.R., Lorenze K.R. Risk factors and outcomes in post-liver transplantation bile duct stones and casts: a case-control study. Liver Transplantat 2008;14(10):1400—3.Spier B.J., Pfau P.R., Lorenze K.R. Risk factors and outcomes in post-liver transplantation bile duct stones and casts: a case-control study. Liver Transplantat 2008;14(10):1400—3.Shastri Y.M., Hoepffner N.M., Akoglu B. et al. Liver biochemistry profile, significance and endoscopic management of biliary tract complications post orthotopicliver transplantation. World J Gastroenterol 2007;13(20):2819—25.Shastri Y.M., Hoepffner N.M., Akoglu B. et al. Liver biochemistry profile, significance and endoscopic management of biliary tract complications post orthotopicliver transplantation. World J Gastroenterol 2007;13(20):2819—25.Zoepf T., Maldonada-Lopez E.J., Hilgard P. et al. Diagnosis of biliary strictures after liver transplantation: Whichis the best tool? World J Gastroenterol 2005;11(19):2945—8.Zoepf T., Maldonada-Lopez E.J., Hilgard P. et al. Diagnosis of biliary strictures after liver transplantation: Whichis the best tool? World J Gastroenterol 2005;11(19):2945—8.Horrow M.M., Blumenthal B.M., Reich D.J., Manzarbeitia C. Sonographic diagnosis and outcome of hepatic artery thrombosis after orthotopic liver transplantation in adults. AJR 2007;189: 346—51.Horrow M.M., Blumenthal B.M., Reich D.J., Manzarbeitia C. Sonographic diagnosis and outcome of hepatic artery thrombosis after orthotopic liver transplantation in adults. AJR 2007;189: 346—51.Patkowski W. Billiary tract complication following liver transplantation. Transplantat Proceedings 2003;35:2316—7.Patkowski W. Billiary tract complication following liver transplantation. Transplantat Proceedings 2003;35:2316—7.Boraschi P., Donati F., Gigoni R. et al. Ischemic-type billiary lesions in liver transplant recipients: evaluation with magnetic resonance cholangiography Transplantat Proceedings 2004;36:2744—7.Boraschi P., Donati F., Gigoni R. et al. Ischemic-type billiary lesions in liver transplant recipients: evaluation with magnetic resonance cholangiography Transplantat Proceedings 2004;36:2744—7.Fulcher A.S., Turner M.A. Orthotopic liver transplantation: Evaluation with MR cholangiography. Radiology 1999;211: 715—22.Fulcher A.S., Turner M.A. Orthotopic liver transplantation: Evaluation with MR cholangiography. Radiology 1999;211: 715—22.Valls C., Alba E., Cruz M. et al. Biliary complications after liver transplantation: diagnosis with MRCholangiopancreatography.AJR 2005;184:812—20.Valls C., Alba E., Cruz M. et al. Biliary complications after liver transplantation: diagnosis with MRCholangiopancreatography.AJR 2005;184:812—20.Laghi A., Pavone P., Catalano C. et al. MR cholangiography of late biliary complications after liver transplantation. AJR 1999;172:1541—6.Laghi A., Pavone P., Catalano C. et al. MR cholangiography of late biliary complications after liver transplantation. AJR 1999;172:1541—6.Londono M., Balderramo D., Cardenas A. Management of biliary complications after orthotopic liver transplantation: the role of endoscopy. World J Gastroenterol 2008;14(4): 493—7.Londono M., Balderramo D., Cardenas A. Management of biliary complications after orthotopic liver transplantation: the role of endoscopy. World J Gastroenterol 2008;14(4): 493—7.Gomez R., Moreno E., Castellon C. et al. Choledochocholedochostomy conversion to hepaticojejunostomy due to biliary obstruction in liver transplantation. World J Surg 2001;25:1308—12.Gomez R., Moreno E., Castellon C. et al. Choledochocholedochostomy conversion to hepaticojejunostomy due to biliary obstruction in liver transplantation. World J Surg 2001;25:1308—12.Belenkey A., Mor E., Bartal G. et al. Transhepaticbaloon dilatation of early biliary strictures in pediatric liver transplantation: succsessful initial and mid-term outcome. Cardiovasc Intervent Radiol 2004;27:491—4.Belenkey A., Mor E., Bartal G. et al. Transhepaticbaloon dilatation of early biliary strictures in pediatric liver transplantation: succsessful initial and mid-term outcome. Cardiovasc Intervent Radiol 2004;27:491—4.Zoepf T., Maldonada-Lopez E.J., Hilgard P. et al. Balloon dilatation vs.balloon dilatation plus bile duct endoprostheses for treatment of anastomoticbiliary strictures after liver transplantation. Liver Transplantat 2006;12:88—94.Zoepf T., Maldonada-Lopez E.J., Hilgard P. et al. Balloon dilatation vs.balloon dilatation plus bile duct endoprostheses for treatment of anastomoticbiliary strictures after liver transplantation. Liver Transplantat 2006;12:88—94.Alazmi W.M., Fogel E.L., Watkins J.L. et al. Recurrence rate of anastomotic biliary strictures in patients who have had previous successful endoscopic therapy for anastomotic narrowing after orthotopic liver transplantation. Endoscopy 2006;38(6):571—4.Alazmi W.M., Fogel E.L., Watkins J.L. et al. Recurrence rate of anastomotic biliary strictures in patients who have had previous successful endoscopic therapy for anastomotic narrowing after orthotopic liver transplantation. Endoscopy 2006;38(6):571—4.Chahal P., Baron T.H., Poterucha J.J., Rosen C.B. Endoscopic retrograde cholangiography in post-orthotopic liver transplant population with Roux-en-Y biliary reconstruction. Liver Transplantat 2007;13: 1168—73.Chahal P., Baron T.H., Poterucha J.J., Rosen C.B. Endoscopic retrograde cholangiography in post-orthotopic liver transplant population with Roux-en-Y biliary reconstruction. Liver Transplantat 2007;13: 1168—73.Davidson B.R., Rai R., Nandy A. et al. Results of choledochojejunostomy in the treatment of biliary complications after liver transplantation in the era of nonsurgical therapies. Liver Transplantat 2000;6(2): 201—6.Davidson B.R., Rai R., Nandy A. et al. Results of choledochojejunostomy in the treatment of biliary complications after liver transplantation in the era of nonsurgical therapies. Liver Transplantat 2000;6(2): 201—6.Zhi-Jun Zhu, Wei Rao, Ji-San Sun et al. Liver retransplantation for ischemic-type biliary lesions after orthotopic liver transplantation: a clinical report of 66 cases. Hepatobiliary Pancreat Dis Int 2008;7(5):471—5.Zhi-Jun Zhu, Wei Rao, Ji-San Sun et al. Liver retransplantation for ischemic-type biliary lesions after orthotopic liver transplantation: a clinical report of 66 cases. Hepatobiliary Pancreat Dis Int 2008;7(5):471—5.Sugawara Y., Sano K., Kaneko J. et al. Duct -to- duct biliary reconstruction for living donor liver transplantation: expiriens of 92 cases. Transplantat Proceedings 2003;35:2981—2.Sugawara Y., Sano K., Kaneko J. et al. Duct -to- duct biliary reconstruction for living donor liver transplantation: expiriens of 92 cases. Transplantat Proceedings 2003;35:2981—2.Haberal M., Boyvat F., Moray G. et al. A new technique for bile duct reconstruction in liver transplantation. Transplantat Proceedings 2006;38:584—8.Haberal M., Boyvat F., Moray G. et al. A new technique for bile duct reconstruction in liver transplantation. Transplantat Proceedings 2006;38:584—8.Haberal M., Karakayali H., Sevmis S. et al. Results of biliary reconstructions in liver transplantation at our center. Transplantat Proceedings 2006;38:2957—60.Haberal M., Karakayali H., Sevmis S. et al. Results of biliary reconstructions in liver transplantation at our center. Transplantat Proceedings 2006;38:2957—60.Bacchella T., Figueira E.R.R., Makdissi F.F. et al. Biliary reconstruction without T-Tube in liver transplantation. Transplantat Proceedings 2004;36:951—2.Bacchella T., Figueira E.R.R., Makdissi F.F. et al. Biliary reconstruction without T-Tube in liver transplantation. Transplantat Proceedings 2004;36:951—2.Moench C., Moench K., Lohse A.W. et al. Prevention of ischemic-type biliary lessons by arterial back-table perfusion. Liver Transplantat 2003;9(3):285—9.Moench C., Moench K., Lohse A.W. et al. Prevention of ischemic-type biliary lessons by arterial back-table perfusion. Liver Transplantat 2003;9(3):285—9.Hampe T. et al. Biliary complications after liver transplantation. Clin Transplant 2006);20(Suppl 17):93—6.Hampe T. et al. Biliary complications after liver transplantation. Clin Transplant 2006);20(Suppl 17):93—6.Lacaille F., Sommacale D., Emond S. et al. Results of living-related liver transplantation and biliary complications in Paris. Transplantat Proceedings 2003;35:961.Lacaille F., Sommacale D., Emond S. et al. Results of living-related liver transplantation and biliary complications in Paris. Transplantat Proceedings 2003;35:961.

The authors declare that there are no conflicts of interest present.