title: A case of successful enteroscopic balloon dilation for late anastomotic stricture of choledochojejunostomy after living donor liver transplantation.
abstract: Biliary complications remain a major concern after living donor liver transplantation. We describe a pediatric case who underwent a successful endoscopic balloon dilatation of biliary-enteric stricture following living donor liver transplantation using a newly developed method of enteroscopy. The 7-year-old boy with late biliary stricture of choledochojejunostomy was admitted 6 years after transplantation. Since percutaneous transhepatic cholangiography was technically difficult in this case, endoscopic retrograde cholangiography was performed using a double-balloon enteroscope under general anesthesia. The enteroscope was advanced retrograde through the duodenum, jejunum, and the leg of Roux-Y by the double-balloon method, and anastomotic stricture of choledochojejunostomy was clearly confirmed by endoscopic retrograde cholangiography and endoscopic direct vision. Balloon dilatation was performed and the anastomosis was expanded. Restenosis was not noted as of 2 years after the treatment. In conclusion, endoscopic balloon dilation of biliary-enteric anastomotic stricture using a new enteroscopic method can be regarded as an alternative choice to percutaneous transhepatic management and surgical re-anatomists.
authors.affiliation: Department of Transplant Surgery, Jichi Medical School, Yakushiji, Minamikawachi, Tochigi 329-0498, Japan.
authors.forename: Hidenori
authors.initials: H
authors.lastname: Haruta
authors.forename: Hironori
authors.initials: H
authors.lastname: Yamamoto
authors.forename: Koichi
authors.initials: K
authors.lastname: Mizuta
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Kita
authors.forename: Takeji
authors.initials: T
authors.lastname: Uno
authors.forename: Satoshi
authors.initials: S
authors.lastname: Egami
authors.forename: Shuji
authors.initials: S
authors.lastname: Hishikawa
authors.forename: Kentaro
authors.initials: K
authors.lastname: Sugano
authors.forename: Hideo
authors.initials: H
authors.lastname: Kawarasaki
mesh_terms: D001653:Bile Ducts, Intrahepatic / Q000000981:diagnostic imaging; D001656:Biliary Atresia / Q000601:surgery; D002404:Catheterization / Q000379:methods*; D002760:Cholangiopancreatography, Endoscopic Retrograde; D002768:Choledochostomy / Q000009:adverse effects*; D001651:Cholestasis, Extrahepatic / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D003251:Constriction, Pathologic / Q000000981:diagnostic imaging / Q000628:therapy; D016099:Endoscopy, Gastrointestinal; D006801:Humans; D007223:Infant; D016031:Liver Transplantation / Q000379:methods*; D008297:Male; D011183:Postoperative Complications