Role of interventional radiology in the treatment of biliary strictures following orthotopic liver transplantation.
OBJECTIVE
To evaluate the efficacy and safety of percutaneous treatment of biliary strictures complicating orthotopic liver transplantation (OLT).


METHODS
Between October 1990 and May 2000, 619 patients underwent 678 liver transplants. Seventy of the 619 (11%) patients were found to be affected by biliary strictures by July 2000. Bilioplasty was performed in 51 of these 70 (73%) patients. A cohort of 33 of 51 (65%) patients were clinically followed for more than 12 months after the last percutaneous treatment and included in the survey results.


RESULTS
After one to three treatments 24 of 33 (73%) patients were stricture-free on ultrasound and MR cholangiography follow-up. A delayed stricture recurrence required a fourth percutaneous bilioplasty in two of 33 (6%) patients. A surgical bilioenteric anastomosis was performed in six of 33 (18%) patients. Retransplantation was performed due to ischemic damage in one of 33 (3%) patients.


CONCLUSIONS
Interventional radiology is an effective therapeutic alternative for the treatment of most biliary strictures complicating OLT. It has a high success rate and should be considered before surgical interventions. Elective surgery may be necessary in a few failed cases or those with more severe and extensive biliary strictures.
Righi
Dorico
D
Istituto di Radiologia Diagnostica ed Interventistica, Universita di Torino, Ospedale Molinette, via Genova 3, I-10126 Turin, Italy.
Cesarani
Federico
F
Muraro
Emanuele
E
Gazzera
Carlo
C
Salizzoni
Mauro
M
Gandini
Giovanni
G
D002779:Cholestasis / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000628:therapy*; D011859:Radiography; D015642:Radiology, Interventional