To investigate the application value of ultrasonography in biliary complications after liver transplantation.

Clinical data of 52 patients who developed biliary complications after liver transplantation and treated in the Third Affiliated Hospital of Sun Yat-sen University between October 2003 and January 2010 were retrospectively studied. The informed consents of all patients were obtained and the local ethical committee approval had been received. Among the 52 patients, 49 were males and 3 were females with the average age of (48±18) years old. Liver grafts were thoroughly examined with color Doppler ultrasound (CDUS). The observation indexes included dilation of bile duct, thickening of bile duct wall, echo enhancement of bile duct wall, narrowing of hilar biliary duct lumen, intraductal echo and acoustic shadow as well as intrahepatic and extrahepatic local dark areas.

The major ultrasonographic manifestations of biliary complications after liver transplantation were 96% (50/52) dilation of bile duct, 75% (39/52) echo enhancement of bile duct wall, 62% (32/52) thickening of bile duct wall, 54% (28/52) narrowing of biliary duct lumen and 37% (19/52) formation of intrahepatic biliary sludge and biliary calculus. The direct ultrasonographic sign of biliary stricture was the narrowing of biliary duct lumen and the indirect signs included dilation of bile duct, thickening of bile duct wall and echo enhancement of bile duct wall. Formation of intrahepatic biliary sludge and biliary calculus manifested a local or diffuse acoustic shadow behind the medium or high echo mass. Bile leakage manifested a local dark space in portal hepatis or subhepatic space. Biloma manifested a dispersed intrahepatic patchy high-echo area or low-echo dark area.

Biliary complications after liver transplantation have typical ultrasonographic signs. Ultrasonography may provide diagnostic evidence for biliary complications after liver transplantation.