Results of endoscopic management of anastomotic biliary strictures after orthotopic liver transplantation

Turk J Gastroenterol. 2006 Sep;17(3):159-63.

Abstract

Background/aims: Anastomotic biliary strictures are common biliary complications after orthotopic liver transplantation. We assessed the success of endoscopic retrograde cholangio-pancreaticography (ERCP) in the treatment and outcome of post-liver transplantation anastomotic biliary strictures in a university hospital, retrospectively.

Methods: Thirty-three ERCPs were performed in 20 of 162 adult liver transplant recipients with duct to duct anastomosis.

Results: In five patients, ERCP failed because the stricture could not be passed with guidewire. Four patients were treated with balloon dilatation only; two of them are recurrence-free with a follow-up of 24 and 8 months. Eleven patients had balloon dilatation and plastic stent placement as their primary treatment modality. In six of them, the anastomosis remained patent for the rest of the follow-up (22+/-13 months). Five patients had stricture recurrence after first stenting which necessitated re-stenting; four of them required a third, and three had a fourth stenting.

Conclusions: Endoscopic balloon dilatation and stenting are safe and effective means of treatment of anastomotic biliary strictures following liver transplantation.

MeSH terms

  • Adolescent
  • Adult
  • Anastomosis, Surgical / adverse effects
  • Biliary Tract / pathology*
  • Catheterization
  • Cholangiopancreatography, Endoscopic Retrograde
  • Cholangitis / etiology
  • Cholangitis / therapy
  • Choledochostomy
  • Cholestasis / etiology*
  • Cholestasis / therapy*
  • Constriction, Pathologic / complications
  • Constriction, Pathologic / etiology
  • Female
  • Follow-Up Studies
  • Humans
  • Liver Cirrhosis / surgery
  • Liver Transplantation*
  • Male
  • Middle Aged
  • Recurrence
  • Reoperation
  • Retrospective Studies
  • Stents
  • Treatment Outcome
  • Turkey