Role of endoscopy in the conservative management of biliary complications after deceased donor liver transplantation

Table 1 A detailed clinical presentation and suggested therapeutic approaches for each condition

Biliary complication	Incidence	Risk factors
Stricture
Anastomotic	4%-12%	Ischemia, surgical complications, duct-to-duct anastomosis
Non-anastomotic	1%-10%	Hepatic artery thrombosis, cold ischemia time, immune conditions (AB0 mismatch), recurrence of underlying PSC, cytotoxic injuries (hydrophobic bile acids)
Leak or fistula	2%-25%	Surgical issues, T-tube removal
Obstruction (stone, cast, sludge, clots)	1%-6%	Stricture, kinking, infections
Cholangitis	10%	Concomitant biliary complications (stricture, obstruction) or maneuvers (ERC, PTC)
Sphincter of Oddi dysfunction	2%-7%	Efferent denervation of papillary region
Hemobilia	1	Endoscopic or percutaneous biliary maneuvers, liver biopsy
Compression
Cystic duct mucocele	Rare	Mucus-producing cells in cystic duct remnant
Periductal Neurinoma	Rare	Unknown
Periductal lymphoma	Rare	Unknown (immunesuppresive therapy?)
Kinking	1.6%	Redundant donor or recipient CBD remnant
Biliary cast syndrome		Hilar stricture, untreated obstruction
Ductopenia (vanishing bile-duct syndrome)	Rare	Drugs (antibiotics, chemotherapy), chronic rejection, ischemia, untreated stricture

¹Only case reports are available in literature. PSC: Primary sclerosing cholangitis; CBD: Common bile duct; ERC: Endoscopic retrograde cholangiography; PTC: Percutaneous trans-hepatic cholangiography.