Long‐term outcomes of early compared to late onset choledochocholedochal anastomotic strictures after orthotopic liver transplantation

Abstract

LT recipients with early ABS have inferior graft survival despite better response to endoscopic intervention.

Management of anastomotic biliary stricture after liver transplantation and impact on survival

“…[6][7][8]24,25,[27][28][29][30][31] This can be explained by the fact that there is no consensus on the definition of post-transplantation AS, as many studies do not specify a definition of AS or do so very imprecisely. 13,27,[32][33][34][35][36] The median time to the occurrence of stenosis is 3 months, but 69.6% of AS occur within 6 months of the transplantation. The majority of studies on the subject seem to corroborate this time to occurrence in the first 6-12 months.…”

Fully covered self-expanding metal stents for benign biliary stricture after orthotopic liver transplant: 5-year outcomes

“…Patients who develop BBS later in the posttransplant period might be expected to have a more benign course after surviving the immediate postoperative period when the risks of postoperative adverse events or graft failure are the highest. 2 Our study had several limitations and considerations affecting interpretation. It was a small prospective study with limited power to estimate patient characteristics associated with the efficacy and safety endpoints, and with no plastic stent comparator.…”

“…2 Even though most clinicians assume early strictures are associated with a better prognosis and generally do not need intensive treatment, the literature on this subject is conflicting. [2][3][4] Symptomatic anastomotic strictures warrant clinical intervention because biliary obstruction can lead to jaundice, cholangitis, common bile duct stones and potentially biliary cirrhosis in chronic cases. 5 Endoscopic management is the first-line treatment for anastomotic strictures after orthotopic liver transplantation (OLT).…”

Anastomotic Biliary Stricture Development after Liver Transplantation in the Setting of Retained Prophylactic Intraductal Pediatric Feeding Tube: Case and Review

“…ABSs can develop at any time following LT, but the majority present within one year of LT (mean 5-8 months) [ 2 ]. ABSs in the early postoperative period are usually related to surgical technique and/or mismatch of recipient and donor bile ducts, while late-onset ABSs are believed to be secondary to fibrosis from preceding local ischemia or chronic inflammation-related injury [ 5 , 6 ]. Historically, several surgical techniques have existed for constructing the biliary anastomosis, with additional measures being employed to deal with significant size mismatch between the donor and recipient bile ducts, as in the case of our patient [ 7 , 8 ].…”