Abstract

Biliary complications after liver transplantation occur in 13∼35% of patients. Biliary cast syndrome, cast formation of biliary sludge along the bile duct, can develop in 4∼18% of liver transplant recipients, although the incidence rate is significantly decreasing due to the improvement of graft harvesting and preservation. It is very important that early diagnosis and effective management of biliary cast syndrome be performed when there is a bile duct stricture or dilatation associated with jaundice and cholangitis in the recipient after liver transplantation, due to the possibility of retransplantation and death of the patient from graft loss. We report a case of a biliary cast formed with suppurative cholangitis and extracted incidentally with a plastic biliary stent during an endoscopic procedure after cadaveric liver transplantation, in which the ERCP findings revealed a stricture at the anastomosis site of the common bile duct and cholangitis. (Korean J Gastrointest Endosc 2007;35:281-286)

• Keywords: Biliary cast syndrome, Cholangitis, Biliary stricture, Liver transplantation