Long-term biliary complications after liver surgery leading to liver transplantation

Chronic biliary obstruction with repeated bouts of cholangitis adversely af fects quality of life and may lead to secondary biliary cirrhosis with live r failure. We reviewed our experience with chronic biliary Complications af ter surgical treatment of various diseases that at the end needed a liver t ransplantation. Twelve patients with previous biliary surgery developed sec ondary biliary cholangitis, secondary biliary cirrhosis, or both. Seven had surgery for liver hydatid disease by Echinococcus granulosus, another four had complicated biliary surgery unrelated to hydatid disease. and one had a history of a traffic accident with liver trauma and hepatectomy with chro nic biliary fistula. The repeated cholangitis attacks and in two cases of h ydatid disease the development of biliary-bronchial fistulas made these pat ients' lives miserable. All had had previous surgical procedures that made the transplantation procedure more difficult. Nevertheless, patient surviva l and graft actuarial survival after liver replacement were 75.0% and 69.2% , respectively, at 5 years.