Paradigm shift in the management of bile duct strictures complicating living donor liver transplantation

Rao, Harshavardhan B.; Koshy, A; Sudhindran, S.; Prabhu, Nirmal Kumar; Venu, Rama P.

doi:10.1007/s12664-019-01000-2

Cited by 4 publications

(6 citation statements)

References 28 publications

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“…BCs are mostly identified in the first three to 12 mo post-LT[ 8 , 17 ]. Similarly, in consistence with other reports[ 7 , 15 , 17 , 30 , 31 , 33 ], we detected BL early in 55/169 (32.5%) patients, and BS in 60/169 (35.5%) patients. The majority of BSs were anastomotic and presented late.…”

Section: Discussionsupporting

confidence: 92%

“…The overall incidence of BC, including BL, biliary infection and BS, in our study was 57.4%. This rate is comparable to previous reports[ 17 , 30 - 33 ]; however, it is higher than other published data[ 8 , 15 , 21 , 34 , 35 ]. This difference can be attributed to the heterogeneous structure between the different studies regarding the type of graft, surgical techniques and the inconsistent inclusion of biliary infection and bile stones as a part of BC.…”

Section: Discussionsupporting

confidence: 87%

“…In a similar management plan as other centres[ 22 , 24 , 29 , 30 , 34 ], minor BLs were treated conservatively; nonetheless, major BL required percutaneous drainage and/or stenting. ERCP was the treatment of choice for all patients.…”

Section: Discussionmentioning

confidence: 99%

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Biliary complications in recipients of living donor liver transplantation: A single-centre study

Guirguis¹,

Nashaat²,

Yassin³

et al. 2021

WJH

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BACKGROUND Biliary complications (BCs) after liver transplantation (LT) remain a considerable cause of morbidity, mortality, increased cost, and graft loss. AIM To investigate the impact of BCs on chronic graft rejection, graft failure and mortality. METHODS From 2011 to 2016, 215 adult recipients underwent right-lobe living-donor liver transplantation (RT-LDLT) at our centre. We excluded 46 recipients who met the exclusion criteria, and 169 recipients were included in the final analysis. Donors’ and recipients’ demographic data, clinical data, operative details and postoperative course information were collected. We also reviewed the management and outcomes of BCs. Recipients were followed for at least 12 mo post-LT until December 2017 or graft or patient loss. RESULTS The overall incidence rate of BCs including biliary leakage, biliary infection and biliary stricture was 57.4%. Twenty-seven (16%) patients experienced chronic graft rejection. Graft failure developed in 20 (11.8%) patients. A total of 28 (16.6%) deaths occurred during follow-up. BCs were a risk factor for the occurrence of chronic graft rejection and failure; however, mortality was determined by recurrent hepatitis C virus infection. CONCLUSION Biliary complications after RT-LDLT represent an independent risk factor for chronic graft rejection and graft failure; nonetheless, effective management of these complications can improve patient and graft survival.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 87%

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Biliary complications in recipients of living donor liver transplantation: A single-centre study

Guirguis¹,

Nashaat²,

Yassin³

et al. 2021

WJH

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“…Post-LDLT biliary strictures are a common catastrophe reaching up to 40% of patients [ 2 , 3 ]. They are anastomotic-/non-anastomotic ones; moreover, they may be angulated, tortuous, twisted, fork-shaped, trident-shaped, multi-branched, long and/or complicated strictures leading to more challenging therapy [ [28] , [29] , [30] ]. However, they can be managed successfully by endoscopy(ERCP ± sphinectrotomy ± ballon dilatation ± stenting) [ 5 , 7 , 9 , [11] , [12] , [13] , 21 , 23 , 27 , [30] , [31] , [32] , [33] , [34] ], by PTBD [ 2 , 7 , 9 , [11] , [12] , [13] , 21 , 23 , [31] , [32] , [33] ] and/or by surgery (HJ) [ 7 , 12 , 21 , 32 , 33 ].…”

Section: Discussionmentioning

confidence: 99%

Biliary complications after adult to adult right-lobe living donor liver transplantation (A-ARLLDLT): Analysis of 245 cases during 16 years period at a single high centre- A retrospective cohort study

Gad

Ayoup

Aziz

et al. 2022

Annals of Medicine &Amp; Surgery

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“…They allow the human body to turn fat into micelles which can then be absorbed in the ileum [7]. The Gallbladder momentarily stores the bile that is produced by the human liver and transferred via the common hepatic duct and the cystic duct [8][9][10] The major goal of the gallbladder is to get rid of the bile, and this is accomplished by a hormone, called cholecystokinin (CCK), that causes the bile to leave the gallbladder [11][12]. The CCK causes the gallbladder to contract and squeeze all the bile right back out to flow through the cystic duct, and continue through the common bile duct which is the last component of what is known as: the biliary tree [13].…”

Section: Introductionmentioning

confidence: 99%

Automatic Intrahepatic Biliary Segmentation Based Image Processing Techniques using Magnetic Resonance Images

Aloudat¹,

Oudat²,

Migdady³

et al. 2020

Preprint

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A set of tubes known as bile ducts connects the liver to an organ below it directly that is called Gallbladder. The dilation of a bile duct is an important indicator regarding any serious issue in the human body. Number of reasons may cause bile duct dilation, such as: stones, tumors which commonly occur due to pancreas or papilla of vater. In this paper, the main contributions are: 1) a novel framework that consists of three phases to be applied on a set of Magnetic Resonance Imaging (MRI) images 2) an extracted set of features with their accurate values that express the condition of the biliary trees from the MRI images. Such dataset can be used in several applications to determine whether a bile duct is dilated or not. The dataset is organized as the following: half of the MRI images are for normal bile ducts, while the other half is for dilated bile ducts. To extract the useful features to diagnose the medical condition of the bile ducts from the MRI images, we implemented and applied the proposed framework that is started by using the enhanced active contour technique without edges in combination with Denoising Convolutional Neural Networks (DnCNN) to perform the segmentation and features extraction process. After that, the output of the segmentation process is the segmented biliary tree that will be used later to extract the needful features to make a diagnostic decision whether there is a dilation or not by comparing the features values of the normal versus the dilated bile ducts. We applied the feed forward neural network with backpropagation training algorithm for classification purposes. According to the experiments, the overall accuracy of the proposed framework was 90.00%. Such approach improves and increases the accuracy of the physicians’ diagnostic decisions which is considered as of significant importance for treatment and cure.

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Paradigm shift in the management of bile duct strictures complicating living donor liver transplantation

Cited by 4 publications

References 28 publications

Biliary complications in recipients of living donor liver transplantation: A single-centre study

Biliary complications in recipients of living donor liver transplantation: A single-centre study

Biliary complications after adult to adult right-lobe living donor liver transplantation (A-ARLLDLT): Analysis of 245 cases during 16 years period at a single high centre- A retrospective cohort study

Automatic Intrahepatic Biliary Segmentation Based Image Processing Techniques using Magnetic Resonance Images

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