MR cholangiopancreatography findings of biliary tract complications after liver  transplantation

Nuray HALİLOĞLU,Ayşe ERDEN,Mustafa Fatih ARSLAN

doi:10.3906/sag-1803-68

Abstract

Background/aim: We aimed to present the magnetic resonance cholangiopancreatography (MRCP) findings of biliary tract complications after liver transplantation. Materials and methods: Seventy-five patients who underwent MRCP in our department between July 2011 and July 2015 after liver transplantation were retrospectively evaluated. The MRCP images were reevaluated by three radiologists in consensus. Diagnostic confirmation of MRCP findings was obtained with direct cholangiographic examinations or with clinical, radiological, and laboratory findings and concordance between MRCP findings and the final diagnosis was investigated. Results: Twenty-seven of the 75 patients had normal MRCP findings and at least one type of biliary tract complication was detected on the MR images of 48 patients. These complications included anastomotic stricture, dilatation of the biliary tract, nonanastomotic stricture, biliary leakage, cholangitis, biloma, abscess due to cholangitis, biliary stone-sludge, and donor-to-recipient bile duct disproportion. Thirty of the 75 patients were followed only by clinical and laboratory findings without further imaging. Forty-five patients underwent direct cholangiographic examinations. At the end of the follow-up period, 28 of the 75 patients were considered free of biliary tract complications, and at least one bile duct complication was diagnosed in 47 patients. Conclusion: With its high sensitivity and specificity, MRCP should be the first choice of method in the diagnosis and follow-up of biliary complications after liver transplantation.

Highlights

Various complications can occur after liver transplantation, and these complications significantly affect the success of the therapy
The most common indication for transplantation was cirrhosis caused by viral hepatitis, in which hepatitis B virus (HBV) infection was more frequent than hepatitis C virus (HCV) infection
Diagnostic confirmation of Magnetic resonance cholangiopancreatography (MRCP) findings was obtained with direct cholangiographic examinations including endoscopic retrograde cholangiopancreatography (ERCP), percutaneous transhepatic cholangiography (PTC), and/or T-tube cholangiography (TTC) or with clinical, radiological, and laboratory findings in the follow-up

Summary

Introduction

Various complications can occur after liver transplantation, and these complications significantly affect the success of the therapy. Bile duct complications are one of the major causes of mortality and morbidity after liver transplantation. Most of the early complications are associated with biliary leakage and occur in the first 3 months. Magnetic resonance cholangiopancreatography (MRCP) is a noninvasive imaging technique that does not require anesthesia and does not use ionizing radiation. It is a common choice of imaging to diagnose pancreatobiliary diseases, and today in many centers it is the preferred method before endoscopic retrograde cholangiopancreatography (ERCP). It gives information about the liver parenchyma and neighboring soft tissues and organs [3]

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