Xiao Y, Cai HQ. Clinical management and therapeutic strategies for biliary leakage after liver transplantation. World J Gastrointest Surg 2025; 17(9): 108275 [DOI: 10.4240/wjgs.v17.i9.108275]
Corresponding Author of This Article
Hong-Qiao Cai, MD, PhD, Department of Hepatobiliary and Pancreatic Surgery, General Surgery Center, The First Hospital of Jilin University, No. 1 Xinmin Street, Changchun 130021, Jilin Province, China. hongqiaocai@jlu.edu.cn
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Editorial
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. Sep 27, 2025; 17(9): 108275 Published online Sep 27, 2025. doi: 10.4240/wjgs.v17.i9.108275
Clinical management and therapeutic strategies for biliary leakage after liver transplantation
Yue Xiao, Hong-Qiao Cai
Yue Xiao, First Operation Room, The First Hospital of Jilin University, Changchun 130000, Jilin Province, China
Hong-Qiao Cai, Department of Hepatobiliary and Pancreatic Surgery, General Surgery Center, The First Hospital of Jilin University, Changchun 130021, Jilin Province, China
Author contributions: Xiao Y contributed to the discussion and design of the manuscript; Cai HQ designed the overall concept and outline of the manuscript, and contributed to the writing, and editing the manuscript, illustrations, and review of literature.
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: Hong-Qiao Cai, MD, PhD, Department of Hepatobiliary and Pancreatic Surgery, General Surgery Center, The First Hospital of Jilin University, No. 1 Xinmin Street, Changchun 130021, Jilin Province, China. hongqiaocai@jlu.edu.cn
Received: April 10, 2025 Revised: April 20, 2025 Accepted: May 9, 2025 Published online: September 27, 2025 Processing time: 168 Days and 2 Hours
Abstract
Biliary leakage is a potentially life-threatening complication following liver transplantation and is associated with significant postoperative morbidity, prolonged hospitalization, and potential graft failure. Its incidence underscores the need for timely diagnosis and effective intervention. Diagnostic modalities such as magnetic resonance cholangiopancreatography and endoscopic retrograde cholangiopancreatography offer both anatomical and functional insights. Endoscopic management with endoscopic retrograde cholangiopancreatography remains the mainstay of treatment, while percutaneous transhepatic cholangiography offers an alternative in patients with altered anatomy or failed endoscopic access. Surgical revision is considered a last resort after other methods have failed. Preventive strategies, including machine perfusion and meticulous surgical techniques, are essential in reducing incidence and improving outcomes. This editorial provides a comprehensive overview of clinical management and therapeutic strategies for biliary leakage after liver transplantation.
Core Tip: Biliary leakage is one of the most common and serious complications following liver transplantation. A structured approach involving prompt diagnosis, effective endoscopic or percutaneous interventions, and judicious use of surgical revision is essential for optimal outcomes. Preventive measures focused on graft preservation and surgical precision are also critical in reducing the incidence and impact of this complication.
