Long-term follow-up of percutaneous transhepatic balloon cholangioplasty in the management of biliary strictures after liver transplantation

Sung, Randall S.; Campbell, Darrell A.; Rudich, Steven M.; Punch, Jeffrey D.; Shieck, Victoria; Armstrong, Joan M.; Ford, Elizabeth; Sullivan, Patricia; Dasika, Narasimham L.; Magee, John C.

doi:10.1097/01.tp.0000101518.19849.c8

Cited by 61 publications

(47 citation statements)

References 18 publications

(7 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Nineteen had to be admitted repeatedly for recurrent bacterial cholangitis (defined as 3 or more episodes). The median number of cholangitis episodes in these 19 was 5 (range [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17]. Thirty patients were placed on maintenance antibiotic therapy, mostly ciprofloxacin, for some time.…”

Section: Cholangitis Episodesmentioning

confidence: 99%

Nonanastomotic biliary strictures after liver transplantation, part 2: Management, outcome, and risk factors for disease progression

et al. 2007

View full text Add to dashboard Cite

Nonanastomotic biliary strictures (NAS) after orthotopic liver transplantation (OLT) are associated with high retransplant rates. The aim of the present study was to describe the treatment of and identify risk factors for radiological progression of bile duct abnormalities, recurrent cholangitis, biliary cirrhosis, and retransplantation in patients with NAS. We retrospectively studied 81 cases of NAS. Strictures were classified according to severity and location. Management of strictures was recorded. Possible prognostic factors for bacterial cholangitis, radiological progression of strictures, development of severe fibrosis/cirrhosis, graft survival, and patient survival were evaluated. Median follow-up after OLT was 7.9 years. NAS were most prevalent in the extrahepatic bile duct. Twenty-eight patients (35%) underwent some kind of interventional treatment, leading to a marked improvement in biochemistry. Progression of disease was noted in 68% of cases with radiological follow-up. Radiological progression was more prevalent in patients with early NAS and one or more episodes of bacterial cholangitis. Recurrent bacterial cholangitis (Ͼ3 episodes) was more prevalent in patients with a hepaticojejunostomy. Severe fibrosis or cirrhosis developed in 23 cases, especially in cases with biliary abnormalities in the periphery of the liver. Graft survival, but not patient survival, was influenced by the presence of NAS. Thirteen patients (16%) were retransplanted for NAS. In conclusion, especially patients with a hepaticojejunostomy, those with an early diagnosis of NAS, and those with NAS presenting at the level of the peripheral branches of the biliary tree, are at risk for progressive disease with severe outcome. Liver Transpl 13: [725][726][727][728][729][730][731][732] 2007. © 2007 AASLD.Received September 19, 2006; accepted February 15, 2007. Biliary complications are common after orthotopic liver transplantation (OLT). Biliary strictures and leakage of bile are most frequently encountered. Strictures are often referred to as anastomotic or nonanastomotic. Nonanastomotic biliary strictures (NAS) are generally considered to be the most troublesome type of biliary complications after liver transplantation, with a graft loss rate of up to 46% after 2 years. 1In a separate study, we have analyzed the radiological characteristics of NAS at the time of diagnosis and risk factors for the development of NAS.2 In this study, we were able to identify statistically significant differences in risk factors for the development of NAS depending on the time of initial presentation. In addition, large variations in anatomical localization and severity of NAS at the time of presentation were found, indicating that NAS is not a single disease but rather a group of biliary abnormalities with different pathogenesis. It is unAbbreviations: NAS, nonanastomotic biliary strictures; OLT, orthotopic liver transplantation; PTCD, percutaneous transhepatic cholangiodrainage; ERCP, endoscopic retrograde cholangiopancreaticography; RR, relati...

show abstract

Section: Cholangitis Episodesmentioning

confidence: 99%

Nonanastomotic biliary strictures after liver transplantation, part 2: Management, outcome, and risk factors for disease progression

et al. 2007

View full text Add to dashboard Cite

show abstract

“…Multiple treatments are often necessary. Long-term patency of percutaneous bilioplasty in adult recipients is reported from 50% to 60% at 5 years [47,48] . Prolonged cold ischemic and operative times, multiple or peripheral strictures and the presence of hepatic artery disease, predispose to treatment failure or a lower patency of anastomotic BS after balloon dilation [48,49] .…”

Section: Biliary Strictures (Bs)mentioning

confidence: 99%

“…Long-term patency of percutaneous bilioplasty in adult recipients is reported from 50% to 60% at 5 years [47,48] . Prolonged cold ischemic and operative times, multiple or peripheral strictures and the presence of hepatic artery disease, predispose to treatment failure or a lower patency of anastomotic BS after balloon dilation [48,49] . The use of cutting balloon catheters or combined cutting and conventional balloon protocol has been proposed in patients with refractory anastomotic stricture [50,51] .…”

Section: Biliary Strictures (Bs)mentioning

confidence: 99%

Interventional radiology procedures in adult patients who underwent liver transplantation

Miraglia

Maruzzelli

Caruso

et al. 2009

WJG

View full text Add to dashboard Cite

Interventional radiology has acquired a key role in every liver transplantation (LT) program by treating the majority of vascular and non-vascular post-transplant complications, improving graft and patient survival and avoiding, in the majority of cases, surgical revision and/or re-transplantation. The aim of this paper is to review indications, technical consideration, results achievable and potential complications of interventional radiology procedures after deceased donor LT and living related adult LT.

show abstract

“…54 Biliary ascariasis can be treated, 55 endoscopic sphincterotomy can be done, 56 intrahepatic stones can be cleared 57 and strictures can be dilated by the transhepatic route. 58 More recent developments have been the design of electrolytic stents that generate their own electrical current to inhibit tumor growth 59 or self-destruct. Covered stents that are less likely to occlude are being tested.…”

Section: University In 1971 Having Graduated In Medicine Frommentioning

confidence: 99%

A tree grows in the liver, and now we can see it

Reuben

2005

Hepatology

View full text Add to dashboard Cite

Long-term follow-up of percutaneous transhepatic balloon cholangioplasty in the management of biliary strictures after liver transplantation

Cited by 61 publications

References 18 publications

Nonanastomotic biliary strictures after liver transplantation, part 2: Management, outcome, and risk factors for disease progression

Nonanastomotic biliary strictures after liver transplantation, part 2: Management, outcome, and risk factors for disease progression

Interventional radiology procedures in adult patients who underwent liver transplantation

A tree grows in the liver, and now we can see it

Contact Info

Product

Resources

About