A case of successful treatment of arterial and biliary complications in a patient after liver transplantation

Abstract

In April, 2018, a 57-year old patient with cirrhosis of the liver (Child-Turcotte-Pugh B class) during the outcome of viral hepatitis B and C was performed Transjugular Intrahepatic Portosystemic Shunt (TIPS); and in June, 2018 – liver transplantation (LТ) from a deceased donor by Piggyback technique. In the postoperative period, abscesses in the left and right lobes of the liver and thrombosis of the hepatic artery thrombosis (HAT) were noticed. Balloon dilatations of biliary stricture with changes of biliary drainage were made during the period of 2 years. In May, 2022, according to the results of angiography, hepatic artery and its branches were seen up to segmental level that meant natural revascularization. Considering the low efficiency of the balloon plastic procedures carried out, there was formed trihepaticojejunostomy on the loop of the small intestine disconnected according to Roux-en-Y. The follow-up period is one and a half years; there are no signs of cholangitis and biliary hypertension.There is no unified scheme of treatment for vascular and biliary complications in the clinics engaged in LТ, because every technique has both advantages and disadvantages. The idea of choice between intervention revascularization, transplantation and surgical reconstruction in the treatment of arterial thrombosis still remains incompletely understood.