Objective    To study the clinical characteristics of and the risk factors for different types of biliary complication (BC) after liver transplantation.     Methods    Clinical data about 172 patients who underwent liver transplantation from August 2004 to March 2010 in our hospital were retrospectively analyzed. Univariate analysis of 45 variables during peri-operation was performed to screen the risk factors for different types of BC after liver transplantation.     Results    BC occurred in 32 cases (21 cases of simple type and 11 cases of complex type) with a BC rate of 18.6%. Biliary leakage

anastomotic biliary stricture (ABS)

non-anastomotic biliary stricture (NABS)

and biliary calculi

infection and hemorrhage occurred in 10 (31.25%)

7（21.88%）

12（37.50%）

11（34.37%）

10（31.25%）

  and 2 (6.25%) cases

respectively. Significant correlations were observed between most types of BC

especially between biliary calculi and infection (C=0.478

P0.01). The proportion of biliary leakage in patients with early BC and that of biliary calculi and infection in patients with late BC were the highest

accounting for 52.90%

46.70% and 46.70%

respectively. Univariate analysis showed that the lower hepatic artery resistive index (RI)

acute and chronic rejection reaction

T-tube indwelling

longer anhepatic phase

preoperative hyperbilirubinemia with a high Child-Pugh score and MELD score might be related with the different types of BC. Modified suture method and increased international normalized ration (INR) might the protective factors for certain types of BC.     Conclusion    There is a significant relation among different types of BC after liver transplantation. Most biliary leakages occur in the early period while most biliary calculi and infection occur in the late period. Biliary stricture may occur both in early and late periods. Many factors are related with different types of BC. Close monitoring of hepatic arterial flow

improving surgery techniques

shortening anhepatic time

no use of T-tube

protection of biliary blood supply

and standard anti-rejection therapy may help to reduce the incidence of BC after liver transplantation.