Abstract:
BACKGROUND:In transplant recipients with choledococholedocostomy (CDCD), endoscopic retrograde cholangiopancreatography (ERCP) remains the gold standard for the diagnosis of biliary leak or strictures. Transabdominal ultrasonography (TAUS) has been used to screen patients with suspected biliary tract complications, prior to ERCP, although the clinical effectiveness remains unclear. AIMS:To assess the predictive value of TAUS in the diagnosis of biliary tract complications after liver transplantation. METHODS:144 consecutive ERCP and corresponding ultrasonogram reports performed over a 67 month period in 79 patients after liver transplantation were analysed retrospectively. RESULTS:77 ERCP patients had both a TAUS and a successful ERCP. Biliary tract abnormalities were found at TAUS in 49 (64%) of the 77 patients. TAUS had an overall sensitivity of 77%, and specificity of 67%, with positive and negative predictive values of 26% and 95% respectively, when adjusted for the prevalence rate of biliary complications after liver transplantation of 12.8% in our population. The use of bile duct calibre as sole criterion for an abnormal scan improved the specificity (76%) and with a corresponding reduction in sensitivity (66%). The risk of false negative TAUS was similar in both the early and late post-transplant periods. CONCLUSIONS:A normal TAUS after liver transplantation with CDCD makes the presence of biliary complications unlikely.
journal_name
Gutjournal_title
Gutauthors
Hussaini SH,Sheridan MB,Davies Mdoi
10.1136/gut.45.6.900keywords:
subject
Has Abstractpub_date
1999-12-01 00:00:00pages
900-3issue
6eissn
0017-5749issn
1468-3288journal_volume
45pub_type
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