Evaluation and management of biliary complications after pediatric liver transplantation: pearls and pitfalls for percutaneous techniques

Monroe, Eric J.; Shin, David S.; Young, Victoria A.; Koo, Kevin S. H.; Woerner, Andrew; Ingraham, Christopher R.

doi:10.1007/s00247-021-05212-7

Cited by 6 publications

(20 citation statements)

References 65 publications

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“…The prevalence of biliary complications after pediatric liver transplantation is estimated to be between 8 and 40% 1 6 7 10 16 and can be subdivided into bile leaks and biliary strictures/obstructions.…”

Section: Indications For Percutaneous Biliary Interventionsmentioning

confidence: 99%

“…There can also be multiple strictures or a combination of both anastomotic and non-anastomotic strictures. 8 10 13 17 19…”

Section: Indications For Percutaneous Biliary Interventionsmentioning

confidence: 99%

“…With the evolvement of split-liver and living-donor liver transplantation particularly for young children, the quantity of pediatric transplantations increased markedly, which also increased the incidence of biliary complications. 3,8,[12][13][14][15] The prevalence of biliary complications after pediatric liver transplantation is estimated to be between 8 and 40% 1,6,7,10,16 and can be subdivided into bile leaks and biliary strictures/obstructions.…”

mentioning

confidence: 99%

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Percutaneous Biliary Interventions in Pediatric Patients

Vogt,

Hammer,

Grözinger

et al. 2024

Digestive Disease Interventions

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Percutaneous biliary interventions have become standard for a variety of indications in pediatric patients. They offer a minimally invasive approach to managing biliary pathologies often associated with liver transplantation and hepatobiliary surgery. Interventions include the insertion of drainage catheters for bilomas, percutaneous transhepatic cholangiography for diagnostic purposes, and percutaneous transhepatic biliary drainage for the treatment of biliary leaks and cholestasis. Sonography, computed tomography, and fluoroscopy are used to guide the procedures. This review aims to demonstrate the indications and technical aspects of percutaneous biliary interventions in pediatric patients with a special focus on radiation protection.

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Section: Indications For Percutaneous Biliary Interventionsmentioning

confidence: 99%

“…There can also be multiple strictures or a combination of both anastomotic and non-anastomotic strictures. 8 10 13 17 19…”

Section: Indications For Percutaneous Biliary Interventionsmentioning

confidence: 99%

mentioning

confidence: 99%

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Percutaneous Biliary Interventions in Pediatric Patients

Vogt,

Hammer,

Grözinger

et al. 2024

Digestive Disease Interventions

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“…Risk factors for the development of BS in pediatric patients are not well established 2,3,6,11–13 . While percutaneous biliary interventions are widely accepted procedures for treating BS in pediatric patients, data regarding their success rates and outcomes have accumulated only in recent years 1,2,5,14–16 . We therefore aimed to determine risk factors for the development of BS and to describe the treatment and outcomes of these patients.…”

Section: Introductionmentioning

confidence: 99%

“…Biliary complications are a significant cause of morbidity and graft loss following pediatric liver transplant (pLT) 1–3 . The incidence of biliary complications has been reported in the range of 8%–45% 1,2 . Complications mainly include biliary leak and biliary strictures (BS).…”

Section: Introductionmentioning

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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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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