Efficacy of endoscopic and percutaneous treatments for biliary complications after cadaveric and living donor liver transplantation

Park, Ju Sang; Kim, Myung–Hwan; Lee, Sung Koo; Seo, Dong Wan; Lee, Sang Soo; Han, Jimin; Min, Young Il; Hwang, Shin; Park, Kwang Min; Lee, Young Joo; Lee, Seung Gyu; Sung, Kyu Bo

doi:10.1067/mge.2003.11

Cited by 173 publications

(136 citation statements)

References 24 publications

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“…Retransplantation was needed in patients with hepatic artery thrombosis or after failure of multiple treatments. Our resolution rate of biliary complications by percutaneous and or endoscopic access was similar to other centers 21 .…”

Section: Discussionsupporting

confidence: 66%

Biliary Complications after Liver Transplantation

Facciuto

2014

Mount Sinai Expert Guides: Hepatology

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Section: Discussionsupporting

confidence: 66%

Biliary Complications after Liver Transplantation

Facciuto

2014

Mount Sinai Expert Guides: Hepatology

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“…[24][25][26][27] Post-transplant calculi and sludge formation are most likely the result of mechanical obstruction mainly strictures, bacterial infection, 6,24 ischemia, biliary reflux, and biliary mucosal inflammation. The ERCP with sphincterotomy is very successful in removing 90-100% of stones or debris in almost all cases.…”

mentioning

confidence: 99%

“…The ERCP with sphincterotomy is very successful in removing 90-100% of stones or debris in almost all cases. 6,16,24,25 Theories as to the etiology of biliary casts include sloughed biliary epithelium due to prolonged cold storage time or transient or ongoing ischemia, chronic rejection, infection, bile stasis, and alteration of the bile milieu. 16 Biliary cast syndrome describes the cholangiographic findings of multiple fixed filling defects in the intrahepatic or extrahepatic biliary tree that conform to the luminal dimensions of the segment of BD.…”

mentioning

confidence: 99%

Post-liver Transplant Biliary Complications

Atwal¹,

Pastrana²,

Sandhu³

2012

Journal of Clinical and Experimental Hepatology

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Biliary tract complications remain a common source of morbidity and mortality in liver transplant (LT) recipients with an estimated incidence of 5-30% after orthotopic LT and a mortality rate of up to 10%. Biliary complications after LT may be related to various factors including hepatic artery thrombosis or stenosis, ischemia reperfusion injury, immunologic injury, infections, donor pool, and technical issues which include imperfect anastomosis and T-tube-related complications. Management of the detected biliary complications includes nonsurgical and surgical methods. A majority of these post transplant biliary complications can be treated with endoscopic retrograde cholangiography. If unsuccessful, a percutaneous intervention or surgery may be required. In this article, we review the incidence, clinical presentation, and management of the main types of biliary complications. (J CLIN EXP HEPATOL 2012;2:81-85)

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“…Nevertheless, no randomized controlled trial has compared the risk/benefit ratios of different endoscopic and percutaneous techniques. A previous study reported that success rate and patency were not different for endoscopic and percutaneous approaches, although percutaneous intervention showed a tendency to be associated with a greater immediate clinical improvement than the endoscopic method (7,19).…”

Section: Discussionmentioning

confidence: 99%

New Strategy in Cases of Failed Endoscopic Intervention of Biliary Strictures after Living Donor Liver Transplantation: Percutaneous Transhepatic Biliary Stent Insertion and Subsequent Endoscopic Treatment

Woo

Kim

Lee

et al. 2012

Korean J Transplant

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Background: In cases of endoscopic intervention treatment for biliary stricture which fail, a percutaneous approach can be subsequently attempted. However, the quality of life is lower for those patients with percutaneous transhepatic biliary drainage (PTBD) tubes than those with endoscopic retrograde biliary drainage tubes. In this study, we report the outcome of the application of percutaneous transhepatic biliary stenting (PTBS) for use in subsequent endoscopic treatment of biliary stricture after living donor liver transplantation (LDLT).Methods: Of 165 patients who underwent LDLT, 40 (24.2%) were diagnosed with anastomotic biliary strictures. Of these patients, seven agreed to treatment using PTBS using a plastic stent with endoscopic follow-up instead of treatment by insertion of a PTBD tube, and were enrolled in this study.Results: In all seven patients, the use of this technique enabled effective advancement of a guide wire and successful placement of one or two plastic stents (7 or 10 Fr) into the PTBD tract. There were no PTBS-related complications associated with the procedure. The median duration for stent use was 40.3 weeks (range; 27.6~65.0). Upon final removal of all stents, the stricture had been resolved in four (57%) of the seven patients.Conclusions: Our study data suggested that, after failed use of ERCP in the treatment of biliary stricture after LDLT, the use of PTBS and ERCP may be an effective and safe treatment.

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Efficacy of endoscopic and percutaneous treatments for biliary complications after cadaveric and living donor liver transplantation

Cited by 173 publications

References 24 publications

Biliary Complications after Liver Transplantation

Biliary Complications after Liver Transplantation

Post-liver Transplant Biliary Complications

New Strategy in Cases of Failed Endoscopic Intervention of Biliary Strictures after Living Donor Liver Transplantation: Percutaneous Transhepatic Biliary Stent Insertion and Subsequent Endoscopic Treatment

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