Long-term outcomes for patients with post-liver transplant anastomotic biliary strictures treated by endoscopic stent placement.
BACKGROUND
Biliary stricture is one of the most common complications of liver transplantation. A number of treatment options are available, but a standard approach has not been established.


METHODS
A total of 25 patients with post-liver transplantation anastomotic strictures were treated endoscopically by stent placement. Long-term outcomes (bile duct patency, morbidity, and mortality) were reviewed retrospectively.


RESULTS
Placement of a stent was attempted in 25 patients with anastomotic stricture. Successful stent placement with stricture resolution at the time of stent removal was noted in 22 patients (technical success 88%). In those 22 patients, long-term success (mean follow-up after all stents removed, 54 months) was observed in 20 patients (90%) and partial success in two (10%). Long term, failure did not occur in any patient. There was no procedure- or disease-related mortally. Three mild episodes of cholangitis occurred during the period while the stents were in place, in relation to 79 endoscopic interventions for a procedure-related complication rate of 3.7%.


CONCLUSIONS
The long-term outcome for patients with post-liver transplantation biliary anastomotic strictures treated with endoscopic stent placement is excellent, with no therapy- or disease-associated mortality and minimal morbidity.
Morelli
Joseph
J
Division of Gastroenterology and Hepatology, Medical University of South Carolina, Charleston, USA.
Mulcahy
Hugh E
HE
Willner
Ira R
IR
Cunningham
John T
JT
Draganov
Peter
P
D000714:Anastomosis, Surgical; D001649:Bile Duct Diseases / Q000453:epidemiology / Q000209:etiology / Q000628:therapy*; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000379:methods; D003251:Constriction, Pathologic / Q000453:epidemiology / Q000628:therapy; D020698:Duodenoscopes; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology* / Q000628:therapy*; D012189:Retrospective Studies; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome