RT Journal Article SR Electronic T1 Role of endoscopic retrograde cholangiopancreatography after orthotopic liver transplantation. JF Gut JO Gut FD BMJ Publishing Group Ltd and British Society of Gastroenterology SP 419 OP 423 DO 10.1136/gut.32.4.419 VO 32 IS 4 A1 O'Connor, H J A1 Vickers, C R A1 Buckels, J A A1 McMaster, P A1 Neuberger, J M A1 West, R J A1 Elias, E YR 1991 UL http://gut.bmj.com/content/32/4/419.abstract AB Twelve of 178 (7%) liver transplant patients underwent endoscopic retrograde cholangiopancreatography (ERCP) after transplantation. The indications for ERCP were persistent or late onset cholestasis, recurrent cholangitis, and suspected biliary leaks or strictures. The time between transplantation and ERCP ranged from 44 to 330 days (median 153 days). Biliary complications diagnosed by ERCP included biliary sludge in the form of casts, calculi, or debris (n = 7); bile leaks (n = 2); a biliary stricture (n = 1), and complete biliary obstruction (n = 1). One patient had a normal cholangiogram after transplantation. Biliary sludge was detected by ultrasound before ERCP in only one of six patients. Eight patients underwent endoscopic papillotomy, followed by clearance of biliary sludge in four and dilatation of a biliary stricture in one. Two patients bled after papillotomy but neither required surgical intervention. At a median follow up of 1.2 years (range 0.5-2.8 years), nine patients are well and three have died. ERCP provides both accurate diagnosis of biliary complications after liver transplantation and treatment that obviates the need for additional surgery in selected patients.