Impact of MRCP findings on the management of biliary strictures in post-living donor liver transplant

Abstract

Background: Biliary strictures are a well-recognized complication of liver transplant. Magnetic resonance cholangiopancreatography (MRCP) is the imaging modality of choice for the diagnosis of post-liver transplant biliary strictures because of its high rate of diagnostic accuracy and limited risk of complications. The purpose of this study was to assess the potential role of MRCP in the diagnosis and management of biliary strictures following living donor liver transplantation (LDLT). Data were retrospectively collected from recipients who had developed biliary stricture following living donor liver transplantation. Informed consent was signed by the patients. All patients were subjected to a proper assessment of history and clinical examination as well as routine laboratory investigations. MRCP was performed to diagnose biliary strictures and to follow cases after management. Results: Analysis involved 32 liver transplant recipients as 28 had anastomotic biliary stricture, 2 had intrahepatic biliary stricture, and 2 had both types (mixed biliary stricture). Management was done in 20 patients by endoscopic therapy and 4 patients by surgical therapy, while 8 patients were exposed only for long-term follow-up. Satisfactory improvement of the biliary stricture was noted in about 16 with endoscopic therapy and 2 with surgical therapy. Conclusion: MRCP is a reliable non-invasive imaging modality for evaluating the biliary stricture following LDLT providing important information on its management.