Role of interventional therapy in hepatic artery stenosis and non-anastomosis bile duct stricture after orthotopic liver transplantation

World J Gastroenterol. 2007 Jun 14;13(22):3128-32. doi: 10.3748/wjg.v13.i22.3128.

Abstract

Aim: To analyze the clinical manifestations and the effectiveness of therapy in patients with orthotopic liver transplantation (OLT)-associated hepatic artery stenosis (HAS) and non-anastomosis bile duct stricture.

Methods: Nine cases were diagnosed as HAS and non-anastomosis bile duct stricture. Percutaneous transluminal angioplasty (PTA) was performed in four HAS cases, and expectant treatment in other five HAS cases; percutaneous transhepatic bile drainage, balloon dilation, stent placement were performed in all nine cases.

Results: Diffuse intra- and extra-bile duct stricture was observed in nine cases, which was associated with bile mud siltation and biliary infection. Obstruction of the bile duct was improved obviously or removed. Life span/follow-up period was 13-30 mo after PTA of four HAS cases, 6-23 mo without PTA of other five cases.

Conclusion: Progressive, non-anastomosis, and diffuse bile duct stricture are the characteristic manifestations of HAS and non-anastomosis bile duct stricture after OLT. These are often associated with bile mud siltation, biliary infection, and ultimate liver failure. Interventional therapy is significantly beneficial.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Angioplasty, Balloon / methods
  • Catheterization / methods
  • Cholestasis / etiology
  • Cholestasis / surgery*
  • Cholestasis / therapy*
  • Constriction, Pathologic / complications
  • Constriction, Pathologic / etiology
  • Female
  • Hepatic Artery / surgery*
  • Humans
  • Liver Transplantation / adverse effects*
  • Male
  • Middle Aged
  • Reperfusion Injury / complications
  • Reperfusion Injury / etiology
  • Retrospective Studies
  • Stents