Evaluation of the liver transplant recipient with suspected biliary obstruction

This figure outlines an approach to liver transplant recipients with suspected biliary obstruction. Clinical features of biliary obstruction include elevated liver enzymes usually in a cholestatic pattern, with or without symptoms (eg, right upper quadrant abdominal pain, fever, jaundice). Refer to content on biliary complications in the liver transplant recipient.

ERC: endoscopic retrograde cholangiography; MRCP: magnetic resonance cholangiopancreatography; PTC: percutaneous transhepatic cholangiography.
*Selecting a method for cholangiogram is informed by the type of biliary anastomosis and the available expertise. For patients with duct-to-duct anastomosis, we usually proceed with ERC. We generally reserve PTC for patients in whom ERC was unsuccessful and for some patients with a Roux-en-Y choledochojejunostomy. ERC can be successfully performed in some patients with Roux-en-Y anatomy with a pediatric colonoscope or with deep small bowel enteroscopy. Refer to content on ERC in patients with Roux-en-Y anatomy.

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خرید پکیج

Evaluation of the liver transplant recipient with suspected biliary obstruction