Transhepatic balloon dilation of biliary strictures in liver transplant patients: a 10-year experience.
OBJECTIVE
The authors report their initial and long-term results using transhepatic balloon dilation to treat biliary strictures in liver transplant patients.


METHODS
Over a 10-year period, 72 liver transplant patients with biliary strictures underwent 81 balloon dilation treatments. Anastomotic strictures were present in 56 patients; nonanastomotic strictures were present in 16.


RESULTS
Initial technical success was achieved in 64 of 72 patients (89%). Balloon dilation failed in eight patients (11%), and they were treated surgically. Complications occurred in nine (12%) patients, and all were successfully treated. Within the first 6 months, five patients (6.9%) required surgical revision. Three patients (4.2%) underwent repeated liver transplantation; and five patients (6.9%) died. Fifty-one patients in whom balloon dilation was initially successful were available for at least a 6-month follow-up. Life-table analysis showed an overall 81% +/- 4.8 success rate at 6 months; it dropped to 70% +/- 6.2 at 6 years. For anastomotic strictures, it was 77% +/- 5.8 at 6 months and 66% +/- 7.3 at 6 years. For nonanastomotic strictures, it was 94% +/- 6.2 at 6 months, which dropped to 84% +/- 10 at 5 years.


CONCLUSIONS
Transhepatic balloon dilation represents an effective and relatively safe treatment for biliary stricture in liver transplant recipients.
Zajko
A B
AB
Department of Radiology, University of Pittsburgh Medical Center, PA 15213, USA.
Sheng
R
R
Zetti
G M
GM
Madariaga
J R
JR
Bron
K M
KM
D000293:Adolescent; D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical / Q000009:adverse effects; D001649:Bile Duct Diseases / Q000601:surgery / Q000628:therapy*; D002404:Catheterization / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D002648:Child; D002675:Child, Preschool; D003251:Constriction, Pathologic / Q000601:surgery / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D015993:Life Tables; D016031:Liver Transplantation / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D012086:Reoperation; D012189:Retrospective Studies; D017211:Treatment Failure; D016896:Treatment Outcome