The balloon dilatation and large profile catheter maintenance method for the management of the bile duct stricture following liver transplantation.
OBJECTIVE
We wanted to evaluate the therapeutic efficacy of the percutaneous balloon dilatation and large profile catheter maintenance method for the management of patients with anastomotic biliary strictures following liver transplant.


METHODS
From May 1999 to June 2003, 12 patients with symptomatic benign biliary stricture complicated by liver transplantation were treated with the percutaneous balloon dilatation and large profile catheter maintenance method (1-6 months). The patients were eight males and four females, and their ages ranged from 20 to 62 years (mean age: 44 years). Ten patients underwent living donor liver transplantation and two underwent cadaveric liver transplantation. Postoperative biliary strictures occurred from two to 21 months (mean age: 18 months) after liver transplantation.


RESULTS
The initial technical success rate was 92%. Patency of the bile duct was preserved for eight to 40 months (mean period: 19 months) in 10 of 12 (84%) patients. When reviewing two patients (17%), secondary balloon dilatations were needed for treating the delayed recurrence of biliary stricture. In one patient, no recurrent stenosis was seen during the further 10 months follow-up after secondary balloon dilatation. Another patient did not response to secondary balloon dilatation, and he was treated by surgery. Eleven of 12 patients (92%) showed good biliary patency for 8-40 months (mean period: 19 months) of follow-up.


CONCLUSIONS
The percutaneous balloon dilatation and large profile catheter maintenance method is an effective therapeutic alternative for the treatment of most biliary strictures that complicate liver transplantation. It has a high success rate and it should be considered before surgery.
Department of Radiology and Center for Imaging Saience, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Sung Wook
SW
Choo
Sung Wook
SW
Shin
Young Soo
YS
Do
Wei Chiang
WC
Liu
Kwang Bo
KB
Park
Yon Mi
YM
Sung
In Wook
IW
Choo
D000328:Adult; D001649:Bile Duct Diseases / Q000209:etiology / Q000628:therapy*; D002404:Catheterization / Q000379:methods*; D002758:Cholangiography; D003251:Constriction, Pathologic / Q000209:etiology / Q000628:therapy; D005260:Female; D006499:Hepatic Artery / Q000000981:diagnostic imaging; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D014463:Ultrasonography