Ostroff J W, Roberts J P, Gordon R L, Ring E J, Ascher N L
Department of Medicine, University of California, San Francisco 94143.
Transplantation. 1990 May;49(5):922-4. doi: 10.1097/00007890-199005000-00018.
Biliary tract problems remain an important cause of complication following orthotopic hepatic transplantation. We describe 12 liver transplantation patients who developed bile peritonitis secondary to a biliary leak after T tube removal. Each of these patients underwent an urgent ERCP that exhibited leakage outside the T tube tract and nondilated intrahepatic ducts. At the time of the ERCP, a nasobiliary catheter was inserted to divert the bile flow. All of these patients resolved their symptoms and closed their leak. We advocate endoscopic placement of a nasobiliary catheter as first-line therapy for significant T tube tract leaks after liver transplantation.
