Bile duct anastomotic stricture after pediatric living donor liver transplantation

Chok, Kenneth S. H.; Chan, See Ching; Chan, Kelvin; Sharr, WW; Tam, Paul Kwong Hang; Fan, Sheung Tat; Lo, Chung Mau

doi:10.1016/j.jpedsurg.2011.12.014

Cited by 27 publications

(32 citation statements)

References 15 publications

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“…Direct clinical investigations and prompt management are often difficult in this setting. The incidence of BCs in this study was 14.5%, which is lower than that in other reports, including the SPLIT database study, in which a BC incidence of 40% after LDLT was described…”

Section: Discussioncontrasting

confidence: 77%

“…An experienced interventional radiology team is paramount, and the success rates of PBIs for children differ in the literature. These differences can be attributed to variations in the distinctive treatment protocols adopted . According to the limited data from the literature shown in Table , it appears that a higher number of PBIs per patient and a longer drainage time are associated with better success rates.…”

Section: Discussionmentioning

confidence: 99%

“…The gold‐standard procedure for the diagnosis and treatment of BSs in patients with a BE anastomosis is percutaneous transhepatic dilatation and drainage. However, there are few reports on the success rates of this procedure after pediatric LDLT . The aim of this study was to describe the clinical scenario of BCs and treatment approaches after pediatric LDLT.…”

mentioning

confidence: 99%

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Diagnosis and management of biliary complications in pediatric living donor liver transplant recipients

et al. 2014

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The incidence of biliary complications (BCs) after living donor liver transplantation (LDLT) can reach 40%. Published data on the pediatric population are limited, and treatment protocols vary. Our aim was to describe the clinical scenario for BCs and treatment approaches after LDLT. Between October 1995 and December 2012, 489 pediatric LDLT procedures were performed. BCs developed in 71 patients (14.5%). Biliary strictures (BSs) developed in 45 (9.2%) patients, and bile leaks (BLs) developed in 33 patients (6.7%). The BL diagnosis was clinical in all cases, and 69.7% of the patients underwent surgery. Nearly half of the BS cases had clinical features or suggestive ultrasound findings. Liver biopsy findings suggested BSs in 51.7%. Percutaneous transhepatic cholangiography was performed in 95.6% of the BS patients. The success rate was 77% [mean number of percutaneous biliary interventions (PBIs) 5 3.9 6 1.98, median drainage time 5 8 months]. In conclusion, BL patients can be managed with conservative therapy, even though most of these patients will ultimately be treated with surgery. Diagnosing a BS requires a high degree of clinical suspicion because the available resources for its identification can fail in up to 50% of cases. A higher number of PBIs and the use of a drainage catheter for a longer time may be required to achieve better results with this technique. Liver Transpl 20:882-892,

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Section: Discussioncontrasting

confidence: 77%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Diagnosis and management of biliary complications in pediatric living donor liver transplant recipients

et al. 2014

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“…The type of transplanted graft has been reported to be an important factor when looking at bile duct complications after liver transplantation. Patients receiving whole liver grafts have lower reported incidence of biliary complications when compared to patients receiving partial grafts from living donors . This has been attributed to the smaller bile duct size and to the questionable integrity of blood supply in partial grafts.…”

Section: Discussionmentioning

confidence: 99%

Outcome of duct‐to‐duct vs. Roux‐en‐Y hepaticojejunostomy biliary anastomoses in below 15‐kg pediatric liver transplant recipients

Shaheen

Alabdulkarim

Hamshow

et al. 2014

Pediatric Transplantation

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The best type of biliary anastomosis to use in lower weight pediatric liver transplant recipients is debatable. In this study, we share a single center's experience comparing the rate of anastomotic biliary complications based on the type of biliary anastomosis performed in this population of patients. A retrospective review of pediatric liver transplants for recipients weighing <15 kg from 11/2003 till 12/2011 was performed. Patients were grouped based on the type of biliary anastomosis into two groups: duct-to-duct (d-d) and Roux-en-Y hepaticojejunostomy (h-j) anastomoses. A total of 24 patients (12 males, 12 females) with a mean age of 26 ± 20 months and a mean weight of 9.27 ± 2.63 kg (range = 5.3-13.9 kg) were studied. All anastomotic complications occurred in patients who received left lateral segments. No statistical differences were found in the post-operative biliary (p = 0.86) or vascular (p = 0.99) complications between the two groups. Acknowledging the limited sample size, our data suggest that duct-to-duct anastomosis can be performed safely in pediatric liver transplantation recipients weighing below 15 kg.

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“…Previous publications have addressed treatment strategies, results, and complication rates with PBI procedures used in the management of BSs in pediatric populations . There are different treatment protocols, and the results vary accordingly.…”

mentioning

confidence: 99%

When is surgery required for the treatment of biliary complications after pediatric liver transplantation?

Neto

Chapchap

2014

Liver Transpl

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Bile duct anastomotic stricture after pediatric living donor liver transplantation

Cited by 27 publications

References 15 publications

Diagnosis and management of biliary complications in pediatric living donor liver transplant recipients

Diagnosis and management of biliary complications in pediatric living donor liver transplant recipients

Outcome of duct‐to‐duct vs. Roux‐en‐Y hepaticojejunostomy biliary anastomoses in below 15‐kg pediatric liver transplant recipients

When is surgery required for the treatment of biliary complications after pediatric liver transplantation?

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