Case Report
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Feb 14, 2015; 21(6): 2000-2004
Published online Feb 14, 2015. doi: 10.3748/wjg.v21.i6.2000
Successful treatment of complex cholangiolithiasis following orthotopic liver transplantation with interventional radiology
Chuan-Guo Zhou, Bao-Jie Wei, Kun Gao, Ding-Ke Dai, Ren-You Zhai
Chuan-Guo Zhou, Bao-Jie Wei, Kun Gao, Ding-Ke Dai, Ren-You Zhai, Department of Radiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
Author contributions: Zhou CG and Zhai RY designed the study; Wei BJ and Gao K were the patient’s attending doctors; Dai DK, Wei BJ and Gao K performed interventional procedures; Zhou CG and Wei BJ organized the report; Zhou CG wrote the paper.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Ren-You Zhai, MD, Professor, Department of Radiology, Beijing Chaoyang Hospital, Capital Medical University, No. 8 Gongren Tiyuchang Nan Road, Chaoyang District, Beijing 100020, China. ryzhai219@hotmail.com
Telephone: +86-10-85231908 Fax: +86-10-65935214
Received: May 18, 2014
Peer-review started: May 19, 2014
First decision: June 10, 2014
Revised: June 28, 2014
Accepted: July 29, 2014
Article in press: July 30, 2014
Published online: February 14, 2015
Processing time: 268 Days and 18.7 Hours
Abstract

Bile duct stones are a serious and the third most common complication of the biliary system that can occur following liver transplantation. The incidence rate of bile duct stones after liver transplantation is 1.8%-18%. The management of biliary stones is usually performed with endoscopic techniques; however, the technique may prove to be challenging in the treatment of the intrahepatic bile duct stones. We herein report a case of a 40-year-old man with rare, complex bile duct stones that were successfully eliminated with percutaneous interventional techniques. The complex bile duct stones were defined as a large number of bile stones filling the intra- and extrahepatic bile tracts, resulting in a cast formation within the biliary tree. Common complications such as hemobilia and acute pancreatitis were not present during the perioperative period. The follow-up period was 20 mo long. During the postoperative period, the patient maintained normal temperature, and normal total bilirubin and direct bilirubin levels. The patient is now living a high quality life. This case report highlights the safety and efficacy of the percutaneous interventional approach in the removal of complex bile duct stones following liver transplantation.

Keywords: Complex bile duct stones; Percutaneous interventional technique; Liver transplantation; Intrahepatic bile tract; Extrahepatic bile tract

Core tip: Bile duct stones are a rare, but serious complication that can occur following liver transplantation and can be very difficult to treat with endoscopic techniques. A case is presented involving a 40-year-old man who developed complex bile duct stones following liver transplantation, with a large number of stones filling the intra- and extrahepatic bile tracts and forming a cast in the biliary tree. The patient’s stones were successfully removed using percutaneous interventional techniques, highlighting the safety and efficacy of this approach in the removal of complex bile duct stones following liver transplantation.