[Technique of biliary reconstruction in liver transplantation and surgical treatment of complications].

Reconstruction of the biliary tree is the last step of a liver transplant procedure. The two techniques currently used are anastomosis of the common bile ducts with or without a Kehr drain and anastomosis to a Roux-en-Y jejunal limb. The latter procedure is usually done when the former is not feasible (missing or abnormal bile duct in the recipient). Biliary complications still occur in 5% to 25% of liver transplant recipients. The most common are fistulas and, above all, stenosis of the anastomosis. Treatment usually requires a surgical procedure to repair the anastomosis, drain a fistula, or perform a Roux-en-Y jejunal anastomosis. However, some complications are amenable to endoscopic or percutaneous treatment.