Fig. 3.

Post-transplantation cholangiographic studies. (A) Intravenous cholangiogram in a 47-year-old recipient of a hepatic homograft, the biliary drainage for which was with Roux-en-Y cholecystojejunostomy (Fig. 2B). The patient’s liver function studies were normal at the time of the examination. However, the findings of a very slightly dilated common duct and air in the biliary system (arrows) are suspicious for low-grade obstruction. (B) A percutaneous transhepatic cholangiogram performed 4 weeks post-transplantation because of persistent elevations of the serum bilirubin (8–10 mg/100 ml). At the time of transplantation, biliary drainage had been established with a Roux-en-Y cholecystojejunostomy (Fig. 2B). After obtaining this study, the patient was re-explored, the gallbladder removed, and the Roux limb anastomosed to the dilated common duct (large arrow), as shown in Fig. 2C. The patient’s jaundice rapidly cleared, and he now has normal liver function 3 months post-transplantation. GB, gallbladder; CD, common bile duct; C, cystic duct.