title: Endoscopic treatment of anastomotic biliary complications after liver transplantation using removable, covered, self-expandable metallic stents.
abstract: OBJECTIVE
  Anastomotic bile duct complications after liver transplantation (LT) have been treated endoscopically by dilation and plastic tube stenting, with the stent therapy having moved toward using covered, self-expandable metallic stents (cSEMS) in recent years. The aim of this study was to analyze therapy outcome of post-LT anastomotic complications using cSEMS.
  
  
  METHODS
  Seventeen post-LT patients had 29 cSEMS (Allium stent, n = 23; Wallstent, n = 4; Micro-Tech, n = 2) placed during endoscopic retrograde cholangiopancreatography (ERCP). The fully covered stents (Allium, Micro-Tech) were placed entirely inside the common bile duct. Data were collected and analyzed in a retrospective manner.
  
  
  RESULTS
  These 17 patients had 19 stent treatment periods. Resolution was eventually established in all patients. There were four (14%) stent migrations. Pancreatitis was seen after one ERCP procedure, whereas five cases of cholangitis were seen.
  
  
  CONCLUSIONS
  Treatment of post-LT anastomotic complications with cSEMS seems to be both safe and efficient. Further assessment regarding indications, stent types and stenting time is needed.
authors.affiliation: Department of Gastrointestinal Surgery, Helsinki University Central Hospital, Helsinki, Finland.
authors.forename: Carola
authors.initials: C
authors.lastname: Haapamäki
authors.forename: Marianne
authors.initials: M
authors.lastname: Udd
authors.forename: Jorma
authors.initials: J
authors.lastname: Halttunen
authors.forename: Outi
authors.initials: O
authors.lastname: Lindström
authors.forename: Heikki
authors.initials: H
authors.lastname: Mäkisalo
authors.forename: Leena
authors.initials: L
authors.lastname: Kylänpää
mesh_terms: D000293:Adolescent; D000328:Adult; D000714:Anastomosis, Surgical / Q000009:adverse effects; D057868:Anastomotic Leak / Q000209:etiology / Q000628:therapy*; D001649:Bile Duct Diseases / Q000209:etiology / Q000628:therapy*; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000009:adverse effects; D003251:Constriction, Pathologic / Q000209:etiology / Q000628:therapy; D005260:Female; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011475:Prosthesis Failure; D012189:Retrospective Studies; D015607:Stents / Q000009:adverse effects; D016896:Treatment Outcome; D055815:Young Adult