Endoscopic treatment of a refractory benign biliary stricture using cholangioscopy-guided thulium laser stricturoplasty

Leonor, Paul A.; Miley, Angelina; Al-Shahrani, Abdullah M

doi:10.1016/j.vgie.2022.03.009

Cited by 4 publications

(3 citation statements)

References 6 publications

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“…This technique, which was initially used in urologic strictures, has been described as an assistant tool for adults with BS. 17,25,26 The strength of this study is by its long-term follow-up, comprehensive and detailed data collection; therefore, it adds to the limited knowledge of risk factors for biliary strictures following pLT and PTBD outcome. The main limitation of this study is the retrospective data collection and that the results originate from a single center.…”

Section: Discussionmentioning

confidence: 99%

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Biliary strictures post pediatric liver transplantation—incidence and risk factors in a single tertiary referral transplant center

Vingrovich,

Cooper,

Gurevich

et al. 2024

Pediatric Transplantation

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BackgroundBiliary strictures are a significant cause of morbidity and graft loss in pediatric liver transplant recipients. Risk factors for the development of biliary strictures are not fully established. We aimed to evaluate the incidence of biliary strictures and treatment modalities outcomes and to identify potential risk factors for occurrence.MethodsPediatric patients who underwent liver transplantation in the single tertiary pediatric liver transplant center in Israel were evaluated. We compared demographics, presentation, laboratory results, imaging, treatment, and outcomes between patients with and without biliary stricture. Multivariate regression analyses were used to identify risk factors for biliary strictures.ResultsAmong 121 pediatric liver transplant patients, 65 (53.7%) were males; the median age at the time of liver transplantation was 43 (3–215) months. Fifteen patients (12.4%) had biliary strictures following transplantation. One (7%) patient with biliary stricture was treated via endoscopic retrograde cholangiopancreatography, and 12 patients (80%) underwent interventions via a percutaneous transhepatic approach. Nine of the 12 patients were treated successfully, requiring one or multiple procedures, while the remaining had surgery or laser therapy. Risk factors for the development of biliary strictures were biliary leak, acute cellular rejection, and the presence of two biliary anastomoses.ConclusionsIn our cohort, the presence of two biliary anastomoses and post‐transplant complications including acute cellular rejection and early biliary leaks were associated with biliary strictures in pediatric liver transplantation recipients. Percutaneous transhepatic interventions result in good outcomes in most patients.

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Section: Discussionmentioning

confidence: 99%

“…Notably, one of our patients underwent a successful treatment trial of BS using laser therapy. This technique, which was initially used in urologic strictures, has been described as an assistant tool for adults with BS 17,25,26 …”

Section: Discussionmentioning

confidence: 99%

Biliary strictures post pediatric liver transplantation—incidence and risk factors in a single tertiary referral transplant center

Vingrovich,

Cooper,

Gurevich

et al. 2024

Pediatric Transplantation

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“…The second one comprises uncommon procedures performed with the use of a cholangioscope. For instance, cases of bile duct reconstruction by rendezvous technique using endoscopic and percutaneous cholangioscopy or treatment of refractory benign biliary stricture using cholangioscopy-guided thulium laser stricturoplasty have been achieved [71][72][73].…”

Section: Innovationsmentioning

confidence: 99%

Cholangioscopy for biliary diseases

Becq

Soualy

Camus

2023

Current Opinion in Gastroenterology

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Purpose of reviewCholangioscopy is a mini-invasive endoscopic procedure, which consists in a direct intraductal visualization of the biliary tract. The purpose of this review is to summarize the technique, the clinical applications, as well as future perspectives of cholangioscopy. Recent findingsNumerous technologic advances during the last decades have allowed for an improved utility and functionality, leading to a broader use of this procedure, for diagnostic or therapeutic purposes, in the setting of biliary diseases. Novel tools and emerging indications have been developed and more are yet to come. SummaryCholangioscopy can be performed by peroral, percutaneous transhepatic or intra-operative transcystic or transcholedochal access. Clinical applications of cholangioscopy are multiple, ranging from visual impression and optical guided biopsies of indeterminate biliary strictures to the management of difficult stones , guidance before biliary stenting and retrieval of migrated ductal stents. Multiple devices such as lithotripsy probes, biopsy forceps, snares and baskets have been developed to help achieve these procedures successfully. Cholangioscopy has improved the way biliary diseases can be visualized and treated. New technology, accessories, and applications are expected in the future.

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Management of anastomotic biliary stricture through utilizing percutaneous transhepatic cholangioscopy

Yasen,

Feng,

Dai

et al. 2024

Clinical Radiology

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Endoscopic treatment of a refractory benign biliary stricture using cholangioscopy-guided thulium laser stricturoplasty

Cited by 4 publications

References 6 publications

Biliary strictures post pediatric liver transplantation—incidence and risk factors in a single tertiary referral transplant center

Biliary strictures post pediatric liver transplantation—incidence and risk factors in a single tertiary referral transplant center

Cholangioscopy for biliary diseases

Management of anastomotic biliary stricture through utilizing percutaneous transhepatic cholangioscopy

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