Ding Y, Xing YX, Sun NZ. Managements of bile leakage after liver transplantation: Commentary on recent findings. World J Gastrointest Surg 2025; 17(7): 108148 [DOI: 10.4240/wjgs.v17.i7.108148]
Corresponding Author of This Article
Nian-Zhe Sun, MD, PhD, Department of Orthopedics, Xiangya Hospital, Central South University, No. 87 Xiangya Road, Kaifu District, Changsha 410008, Hunan Province, China. sunnzh201921@sina.com
Research Domain of This Article
Surgery
Article-Type of This Article
Letter to the Editor
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Surg. Jul 27, 2025; 17(7): 108148 Published online Jul 27, 2025. doi: 10.4240/wjgs.v17.i7.108148
Managements of bile leakage after liver transplantation: Commentary on recent findings
Yi Ding, Yi-Xuan Xing, Nian-Zhe Sun
Yi Ding, Nian-Zhe Sun, Department of Orthopedics, Xiangya Hospital, Central South University, Changsha 410008, Hunan Province, China
Yi Ding, Department of Pulmonary and Critical Care Medicine, The Second Hospital of Jilin University, Changchun 130041, Jilin Province, China
Yi-Xuan Xing, Department of Emergency, Xiangya Hospital, Central South University, Changsha 410008, Hunan Province, China
Yi-Xuan Xing, Nian-Zhe Sun, National Clinical Research Center of Geriatric Disorders, Xiangya Hospital, Central South University, Changsha 410008, Hunan Province, China
Co-corresponding authors: Yi-Xuan Xing and Nian-Zhe Sun.
Author contributions: Ding Y, Xing YX, and Sun NZ designed the concept and outline and contributed to the writing and review of literature; Sun NZ was responsible for oversight and coordination; Xing YX and Sun NZ contributed equally to this article, they are the co-corresponding authors of this manuscript; and all authors contributed to the editing of the manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Nian-Zhe Sun, MD, PhD, Department of Orthopedics, Xiangya Hospital, Central South University, No. 87 Xiangya Road, Kaifu District, Changsha 410008, Hunan Province, China. sunnzh201921@sina.com
Received: April 7, 2025 Revised: April 26, 2025 Accepted: June 3, 2025 Published online: July 27, 2025 Processing time: 108 Days and 8.4 Hours
Abstract
Bile leakage remains a formidable challenge in post-liver transplantation management, posing significant risks to patient outcomes and graft survival. This editorial provides a critical appraisal of the recent clinical study by Gu et al, which compared the efficacy of stent placement vs endoscopic nasobiliary drainage (ENBD) for treating post-transplant bile leaks. By retrospectively analyzing data from their institutional cohort of liver transplant recipients with bile leaks, the authors evaluated the therapeutic success rates and clinical outcomes between the stent and ENBD groups, with a focused discussion on the relative advantages of each approach. Gu et al demonstrated that both stent placement and ENBD were effective in managing post-transplant bile leaks, with comparable therapeutic outcomes. However, the study also recognized its limitations, such as the lack of an assessment of the impact of bile leak severity on outcome and the absence of long-term follow-up data. The editorial further highlights the pressing need for advancing research on long-term complications post-liver transplantation and underscores the pivotal role of clinical stratification and physician expertise in guiding therapeutic decisions. In summary, Gu et al’s study enhances our understanding of mitigating post-transplant complications like bile leaks and offers evidence-based insights to refine clinical protocols. This commentary aims to contextualize current research trends and future directions in the field, advocating for sustained innovation and evidence-driven practice.
Core Tip: Both stent placement and endoscopic nasobiliary drainage are effective in controlling bile leakage after liver transplantation and both have high success rates. They are both minimally invasive procedures that can be tailored to patient-specific factors such as biliary stricture or risk of infection. Recent advances in endoscopic techniques and stent design continue to improve their efficacy and safety, making them the preferred first-line treatment for managing bile leaks after liver transplantation.
