# Choledocholithiasis Following an Orthotopic Liver Transplant: A Case Report and Brief Review of the Literature

## TL;DR

A liver transplant patient developed bile duct stones due to a stricture, successfully treated with endoscopic therapy.

## Contribution

This case report highlights endoscopic management of choledocholithiasis following liver transplant.

## Key findings

- Choledocholithiasis occurred secondary to a duct-to-duct anastomotic biliary stricture.
- Endoscopic retrograde cholangiopancreatography and stent placement effectively managed the complication.
- Timely intervention prevented graft failure and re-transplantation.

## Abstract

With advancements in transplant surgery, an orthotopic liver transplant remains the definitive treatment for end-stage liver disease. However, biliary complications, particularly strictures and choledocholithiasis, are among the most common causes of post-transplant morbidity and can significantly impact graft survival. Prompt recognition and timely intervention are essential to prevent progression to graft failure or the need for re-transplantation. We report a case of an orthotopic liver transplant patient who developed choledocholithiasis secondary to a duct-to-duct anastomotic biliary stricture. The patient was successfully managed with endoscopic retrograde cholangiopancreatography and biliary duct stent placement. This case highlights the importance of clinician awareness and the role of endoscopic therapy in the effective management of post-transplant biliary complications.