TY - JOUR
T1 - Management of biliary anastomotic strictures after liver transplantation
AU - Koksal, Aydin Seref
AU - Eminler, Ahmet Tarik
AU - Parlak, Erkan
AU - Gurakar, Ahmet
N1 - Publisher Copyright:
© 2017 Elsevier Inc.
Copyright:
Copyright 2017 Elsevier B.V., All rights reserved.
PY - 2017/7
Y1 - 2017/7
N2 - Biliary strictures constitute 40% to 60% of the biliary complications after liver transplantation. They are more common after living donor related liver transplantation (LDLT) than orthotopic liver transplantation (OLT). Balloon dilation followed by multiple plastic stent insertion leads to a mean resolution rate of 84% in the treatment of ASs after OLT. Endoscopic treatment of ASs after LDLT is more difficult because of the small size of the ASs, their multiple number and peripheral location. Balloon dilation followed by multiple plastic stent insertion had a mean resolution rate of 53%. Percutaneous transhepatic biliary drainage was required in 16% to 44% of the patients. Refractory cases with complete biliary obstruction and severe stenosis, in whom the stricture could not be traversed with a guidewire, can be treated by magnetic compression anastomosis as a rescue therapy, if the anatomy of the bile ducts is suitable. In this review, we will focus on the endoscopic treatment of ASs, with special emphasis to refractory cases.
AB - Biliary strictures constitute 40% to 60% of the biliary complications after liver transplantation. They are more common after living donor related liver transplantation (LDLT) than orthotopic liver transplantation (OLT). Balloon dilation followed by multiple plastic stent insertion leads to a mean resolution rate of 84% in the treatment of ASs after OLT. Endoscopic treatment of ASs after LDLT is more difficult because of the small size of the ASs, their multiple number and peripheral location. Balloon dilation followed by multiple plastic stent insertion had a mean resolution rate of 53%. Percutaneous transhepatic biliary drainage was required in 16% to 44% of the patients. Refractory cases with complete biliary obstruction and severe stenosis, in whom the stricture could not be traversed with a guidewire, can be treated by magnetic compression anastomosis as a rescue therapy, if the anatomy of the bile ducts is suitable. In this review, we will focus on the endoscopic treatment of ASs, with special emphasis to refractory cases.
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U2 - 10.1016/j.trre.2017.03.002
DO - 10.1016/j.trre.2017.03.002
M3 - Review article
C2 - 28427741
AN - SCOPUS:85017470056
SN - 0955-470X
VL - 31
SP - 207
EP - 217
JO - Transplantation Reviews
JF - Transplantation Reviews
IS - 3
ER -