Liver transplant bile duct suture leading to acute cholangitis: endoscopic removal via cholangioscopy

Acute cholangitis occurs from biliary obstruction. Gallstones, strictures and neoplasia account for most cases [1]. Sutures from prior surgical interventions have previously been described as leading to obstruction [2]. We present a case of a patient who had undergone orthotopic liver transplantation with duct-to-duct anastomosis 4 years previously and developed acute cholangitis ultimately due to a retained suture at the site of the biliary anastomosis ([Video 1]). This suture was successfully removed endoscopically to prevent future recurrences.