Outcome of ERCP in the management of duct-to-duct anastomotic strictures in orthotopic liver transplant.
This study sought to determine the efficacy of endoscopic treatment of duct-to-duct anastomotic stricture in orthotopic liver transplant. A retrospective chart and database review was carried out using procedure and diagnosis codes during the period of 1997-2001. One hundred ninety-eight adult patients underwent orthotopic liver transplantation from 1997 to 2001. Fifteen patients (age 52+/-9 years; 60% women) with duct-to-duct anastomotic strictures were identified. They underwent a total of 53 endoscopic retrograde cholangiopancreatographies (ERCPs) and received different endoscopic treatments including biliary dilation, stent placement, and sphinctrerotomy. Thirteen of these patients (87%) had complete resolution of stricture. Of the remaining two patients, one had partial resolution of stricture and underwent long-term self-expanding metal stenting, while the other had no resolution after two ERCPs. We conclude that ERCP was effective in treating 87% of the duct-to-duct anastomotic strictures in this series.
Elmi
Farshad
F
Division of General Internal Medicine, Department of Internal Medicine, University of Iowa Hospitals and Clinics, Iowa City, Iowa 52242, USA.
Silverman
William B
WB
D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical / Q000009:adverse effects / Q000379:methods; D001652:Bile Ducts / Q000601:surgery*; D002404:Catheterization / Q000379:methods*; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000379:methods*; D002779:Cholestasis / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects* / Q000379:methods; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D019919:Prosthesis Implantation / Q000295:instrumentation*; D012086:Reoperation; D012189:Retrospective Studies; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome