Vernuccio F, Mercante I, Tong XX, Crimì F, Cillo U, Quaia E. Biliary complications after liver transplantation: A computed tomography and magnetic resonance imaging pictorial review. World J Gastroenterol 2023; 29(21): 3257-3268 [PMID: 37377585 DOI: 10.3748/wjg.v29.i21.3257]
Corresponding Author of This Article
Federica Vernuccio, MD, PhD, Staff Physician, Department of Radiology, University Hospital of Padova, 2 Via Nicolò Giustiniani, Padova 35128, Italy. federicavernuccio@gmail.com
Research Domain of This Article
Radiology, Nuclear Medicine & Medical Imaging
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
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/
Federica Vernuccio, Department of Radiology, University Hospital of Padova, Padova 35128, Italy
Irene Mercante, Xiao-Xiao Tong, Filippo Crimì, Emilio Quaia, Department of Radiology-DIMED, University of Padova, Padova 35128, Italy
Umberto Cillo, Department of Surgery, Hepatobiliary Surgery and Liver Transplant Center, Oncology and Gastroenterology (DISCOG), University of Padova, Padova 35128, Italy
Author contributions: Vernuccio F conceptualized the manuscript, wrote the outline of the manuscript, prepared some of the figures, and extensively revised the draft of the manuscript; Mercante I and Tong XX performed the literature search, wrote the first draft of the manuscript, and prepared most of the figures; Crimì F and Cillo U revised the draft of the manuscript and provided input; Quaia E conceptualized the manuscript, provided input, and revised the draft of the manuscript.
Conflict-of-interest statement: The authors report having no relevant conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Federica Vernuccio, MD, PhD, Staff Physician, Department of Radiology, University Hospital of Padova, 2 Via Nicolò Giustiniani, Padova 35128, Italy. federicavernuccio@gmail.com
Received: January 6, 2023 Peer-review started: January 6, 2023 First decision: March 18, 2023 Revised: March 23, 2023 Accepted: April 27, 2023 Article in press: April 27, 2023 Published online: June 7, 2023
Abstract
Biliary complications are the most common complications after liver transplantation. Computed tomography (CT) and magnetic resonance imaging (MRI) are cornerstones for timely diagnosis of biliary complications after liver transplantation. The diagnosis of these complications by CT and MRI requires expertise, mainly with respect to identifying subtle early signs to avoid missed or incorrect diagnoses. For example, biliary strictures may be misdiagnosed on MRI due to size mismatch of the common ducts of the donor and recipient, postoperative edema, pneumobilia, or susceptibility artifacts caused by surgical clips. Proper and prompt diagnosis of biliary complications after transplantation allows the timely initiation of appropriate management. The aim of this pictorial review is to illustrate various CT and MRI findings related to biliary complications after liver transplantation, based on time of presentation after surgery and frequency of occurrence.
Core Tip: Biliary complications are the most common surgical complications after liver transplantation, and represent a major source of morbidity and mortality in liver transplant recipients. Magnetic resonance cholangiopancreatography is the gold standard for the non-invasive diagnosis of intra- and extrahepatic biliary complications. Computed tomography may also be helpful for the assessment of biliary complications, and it is often used due to its more widespread availability as compared to that of magnetic resonance imaging.
