Results of endoscopic management of anastomotic biliary strictures after orthotopic liver transplantation.
OBJECTIVE
Anastomotic biliary strictures are common biliary complications after orthotopic liver transplantation. We assessed the success of endoscopic retrograde cholangio-pancreaticography (ERCP) in the treatment and outcome of post-liver transplantation anastomotic biliary strictures in a university hospital, retrospectively.


METHODS
Thirty-three ERCPs were performed in 20 of 162 adult liver transplant recipients with duct to duct anastomosis.


RESULTS
In five patients, ERCP failed because the stricture could not be passed with guidewire. Four patients were treated with balloon dilatation only; two of them are recurrence-free with a follow-up of 24 and 8 months. Eleven patients had balloon dilatation and plastic stent placement as their primary treatment modality. In six of them, the anastomosis remained patent for the rest of the follow-up (22+/-13 months). Five patients had stricture recurrence after first stenting which necessitated re-stenting; four of them required a third, and three had a fourth stenting.


CONCLUSIONS
Endoscopic balloon dilatation and stenting are safe and effective means of treatment of anastomotic biliary strictures following liver transplantation.
Akay
Sinan
S
Department of Gastroenterology, Ege University Medical Faculty, Izmir, Turkey. sinanakay72@hotmail.com
Karasu
Zeki
Z
Ersöz
Galip
G
Kiliç
Murat
M
Akyildiz
Murat
M
Günşar
Fulya
F
Akarca
Ulus
U
Batur
Yücel
Y
Ilter
Tankut
T
D000293:Adolescent; D000328:Adult; D000714:Anastomosis, Surgical / Q000009:adverse effects; D001659:Biliary Tract / Q000473:pathology*; D002404:Catheterization; D002760:Cholangiopancreatography, Endoscopic Retrograde; D002761:Cholangitis / Q000209:etiology / Q000628:therapy; D002768:Choledochostomy; D002779:Cholestasis / Q000209:etiology* / Q000628:therapy*; D003251:Constriction, Pathologic / Q000150:complications / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008103:Liver Cirrhosis / Q000601:surgery; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012086:Reoperation; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome; D014421:Turkey