Bile Duct Anastomosis Supplied With Biodegradable Stent in Liver Transplantation: The Initial Experience

Janoušek, L; Malý, Štěpán; Oliverius, Martin; Kočík, Matěj; Kučera, Miloš; Froněk, Jiří

doi:10.1016/j.transproceed.2016.09.039

Cited by 17 publications

(11 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…At this regard we should also take in consideration the possibility to use the new generation absorbable stent developed recently which can be placed through endoscopic or surgical approach (29)(30)(31).…”

Section: Discussionmentioning

confidence: 99%

Case Report: Trans-Papillary Free Stenting of the Cystic Duct and of the Common Bile Duct in A Double Biliary Ducts Anastomoses of A Right Lobe Living Donor Transplantation

Gruttadauria

Tropea

Pagano

et al. 2020

Preprint

View full text Add to dashboard Cite

Background One of the major issues related to the living donor liver transplantation recipient outcome is still the high rate of biliary complication, especially when multiple biliary ducts are present and multiple anastomoses have to be performed.Case Presentation and Conclusion We report a case of adult-to-adult right lobe living donor liver transplantation performed for a recipient affected by alcohol-related cirrhosis with MELD score of 17. End-stage liver disease was complicated by refractory ascites, portal hypertension, small esophageal varices and portal gastropathy, hypersplenism, and abundant right pleural effusion. Here in the attached video we described the adult-to-adult LDLT procedures, where a right lobe with two biliary ducts draining respectively the right anterior and the right posterior segments has been transplanted. LDLT required a biliary reconstruction using the native cystic and common bile ducts stented trans-papillary with two 5- French 6 cm long soft silastic catheter. None major complications were detected during post-operative clinical courses. Actually, the donor and the recipient are alive and well.The technique we describe in the video, allow to keep the biliary anastomoses protected and patent without having the risk of creating cholestasis and the need of invasive additional procedure. No living donor right lobe transplantation should be refused because of the presence of multiple biliary ducts.

show abstract

Section: Discussionmentioning

confidence: 99%

Case Report: Trans-Papillary Free Stenting of the Cystic Duct and of the Common Bile Duct in A Double Biliary Ducts Anastomoses of A Right Lobe Living Donor Transplantation

Gruttadauria

Tropea

Pagano

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…In an effort to minimize the need for endoscopic procedures for stent removal, studies have since been performed using synthetic bioabsorbable stents [ 15 ]. Janousek et al investigated the use of transanastomotic bioabsorbable biliary stents, made from polydioxanone monofilaments.…”

Section: Discussionmentioning

confidence: 99%

“…Janousek et al investigated the use of transanastomotic bioabsorbable biliary stents, made from polydioxanone monofilaments. None of the patients in the stent group developed biliary strictures; however, the sample size was small, and long term follow-up was not reported [ 15 ]. Most recently, the first randomized control trial assessing the efficacy of prophylactic transanastomotic stenting for duct-to-duct biliary reconstruction in LT was performed [ 16 ].…”

Section: Discussionmentioning

confidence: 99%

“…Most recently, the first randomized control trial assessing the efficacy of prophylactic transanastomotic stenting for duct-to-duct biliary reconstruction in LT was performed [ 16 ]. Santosh Kumar et al randomized LT recipients to either receive a transanastomotic, transpapillary 3-5 Fr ureteric stent or no stent; the authors reported a trend towards higher stricture formation in the stent group compared to the nonstent group (22.6% versus 6.1%), although this was not statistically significant [ 15 ]. Given a significantly higher risk of bile leak in the stent group, the trial was terminated early [ 16 ].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Anastomotic Biliary Stricture Development after Liver Transplantation in the Setting of Retained Prophylactic Intraductal Pediatric Feeding Tube: Case and Review

Koo

Medici

Tabibian

2018

Case Reports in Hepatology

View full text Add to dashboard Cite

The biliary anastomosis remains a common site of postoperative complications in liver transplantation (LT). Biliary complications have indeed been termed the “Achilles' heel” of LT, and while their prevention, diagnosis, and treatment have continued to evolve over the last two decades, various challenges and uncertainties persist. Here we present the case of a 33-year-old man who, 10 years after undergoing LT for idiopathic recurrent intrahepatic cholestasis, was noted to have developed pruritus and abnormalities in serum liver biochemistries during routine post-liver transplant follow-up. Abdominal ultrasound revealed a linear, 1.5 mm hyperechoic filling defect in the common bile duct; magnetic resonance cholangiopancreatography demonstrated a curvilinear filling defect at the level of the choledochocholedochostomy, corresponding to the ultrasound finding, as well as an anastomotic biliary stricture (ABS). On endoscopic retrograde cholangiography (ERC), a black tubular stricture with overlying sludge was encountered and extracted from the common bile duct, consistent with a retained 5 Fr pediatric feeding tube originally placed at the time of LT. The patient experienced symptomatic and biochemical relief and successfully underwent serial ERCs with balloon dilatation and maximal biliary stenting for ABS management. With this case, we emphasize the importance of ensuring spontaneous passage or removal of intraductal prostheses placed prophylactically at the time of LT in order to minimize the risk of chronic biliary inflammation and associated sequelae, including cholangitis and ABS formation. We also provide herein a brief review of the use of prophylactic internal transanastomotic prostheses, including biliary tubes and stents, during LT.

show abstract

“…In contemporary medicine, we have some opportunities to diagnose and treat this complication by dilatation and stenting via endoscope, transhepatic drainage or by surgical procedure as the last step. Only few authors have focused on the prevention of a stricture during surgery in their studies (Luo et al 2013;Shi et al 2013;Janousek et al 2016). As a solution to the disadvantages connected with the placement, occlusion, migration and extraction of the commonly used plastic or more recently covered metallic stent, the biodegradable self-expandable polydioxanone stent has been studied in a preventive setting.…”

mentioning

confidence: 99%

Duodenum sparing technique for preventive stenting of biliary tract anastomosis in pigs

et al. 2019

View full text Add to dashboard Cite

The main aim of this study was to find a standardized method for preventive stenting of biliary tract anastomosis with biodegradable self-expandable stent from polydioxanone and to evaluate the functionality of the stent. The experimental study was conducted using four pigs with a follow-up of eight weeks. The procedure was done under general anaesthesia. The function of the stent was verified by clinical stage, blood test, magnetic resonance cholangiopancreatography and necropsy. Our duodenum sparing technique was described in detail and photographically documented. All pigs finished the follow-up period without clinical, laboratory or radiologic signs of biliary obstruction. Necropsy did not reveal complication of the procedure or anastomotic stricture. In conclusion, this study demonstrated a simple new duodenum sparing method of transanastomotic insertion of a biodegradable self-expandable stent from polydioxanone. We did not find any complications during the follow-up. This method will be used in our follow-up study with an extended experimental control group of animals and a longer follow-up period to verify the preventive functionality of this stent.

show abstract

Bile Duct Anastomosis Supplied With Biodegradable Stent in Liver Transplantation: The Initial Experience

Cited by 17 publications

References 10 publications

Case Report: Trans-Papillary Free Stenting of the Cystic Duct and of the Common Bile Duct in A Double Biliary Ducts Anastomoses of A Right Lobe Living Donor Transplantation

Case Report: Trans-Papillary Free Stenting of the Cystic Duct and of the Common Bile Duct in A Double Biliary Ducts Anastomoses of A Right Lobe Living Donor Transplantation

Anastomotic Biliary Stricture Development after Liver Transplantation in the Setting of Retained Prophylactic Intraductal Pediatric Feeding Tube: Case and Review

Duodenum sparing technique for preventive stenting of biliary tract anastomosis in pigs

Contact Info

Product

Resources

About