title: Long-term placement of subcutaneous Rüsch-type stents for double biliary stenosis in a living-donor liver transplant recipient.
abstract: Biliary reconstruction continues to be a major source of morbidity following liver transplantation. The spectrum of biliary complications is evolving due to the increasing number of split-liver and living-donor liver transplantation, which are even associated with a higher incidence of biliary complications. Bile duct strictures are the most common cause of late biliary complications and account for up to 40% of all biliary complications. Optimal therapy for posttransplantation anastomotic biliary strictures remains uncertain and requires a multidisciplinary approach. We report the case of a 54-year-old Caucasian male affected by hepatocarcinoma and hepatitis C-related cirrhosis who underwent right-lobe living-donor liver transplantation from his son complicated by double anastomotic stenosis of the main right hepatic duct and of an accessory biliary duct draining segments 6 and 7 of the graft that was successfully treated by percutaneous transhepatic cholangiography with long-term subcutaneous placement of two internal Rüsch-type biliary stents.
authors.affiliation: Department of Surgery and Transplantation, Udine University School of Medicine, 33100 Udine, Italy. adanigl@hotmail.com
authors.forename: Gian Luigi
authors.initials: GL
authors.lastname: Adani
authors.forename: Umberto
authors.initials: U
authors.lastname: Baccarani
authors.forename: Dario
authors.initials: D
authors.lastname: Lorenzin
authors.forename: Andrea
authors.initials: A
authors.lastname: Risaliti
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Como
authors.forename: Daniele
authors.initials: D
authors.lastname: Gasparini
authors.forename: Massimo
authors.initials: M
authors.lastname: Sponza
authors.forename: Vittorio
authors.initials: V
authors.lastname: Bresadola
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Bresadola
mesh_terms: D001662:Biliary Tract Surgical Procedures / Q000295:instrumentation; D006528:Carcinoma, Hepatocellular / Q000601:surgery; D001651:Cholestasis, Extrahepatic / Q000209:etiology* / Q000601:surgery; D004108:Dilatation, Pathologic / Q000209:etiology / Q000601:surgery; D006500:Hepatic Duct, Common / Q000473:pathology / Q000601:surgery; D006801:Humans; D008113:Liver Neoplasms / Q000601:surgery; D016031:Liver Transplantation / Q000009:adverse effects*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D012086:Reoperation; D015607:Stents