title: Alternative techniques for cannulation of biliary strictures resistant to the 0.035" system following living donor liver transplantation.
abstract: OBJECTIVE
  To assess the clinical efficacy of alternative techniques for biliary stricture cannulation in patients undergoing living donor liver transplantation (LDLT), after cannulation failure with a conventional (0.035-inch guidewire) technique.
  
  
  METHODS
  Of 293 patients with biliary strictures after LDLT, 19 (6%) patients, 11 men and 8 women of mean age 48.5 years, had the failed cannulation of the stricture by conventional techniques. Recannulation was attempted by using two alternative methods, namely a micro-catheter set via percutaneous access and a snare (rendezvous) technique using percutaneous and endoscopic approaches.
  
  
  RESULTS
  Strictures were successfully cannulated in 16 (84%) of the 19 patients. A microcatheter set was used in 12 and a snare technique in four patients. Stricture cannulation failed in the remaining three patients, who finally underwent surgical revision.
  
  
  CONCLUSIONS
  Most technical failures using a conventional technique for biliary stricture cannulation after LDLT can be overcome by using a microcatheter set or a snare (rendezvous) technique.
authors.affiliation: Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Hee Mang
authors.initials: HM
authors.lastname: Yoon
authors.forename: Jin Hyoung
authors.initials: JH
authors.lastname: Kim
authors.forename: Gi-Young
authors.initials: GY
authors.lastname: Ko
authors.forename: Ho-Young
authors.initials: HY
authors.lastname: Song
authors.forename: Dong Il
authors.initials: DI
authors.lastname: Gwon
authors.forename: Kyu-Bo
authors.initials: KB
authors.lastname: Sung
mesh_terms: D000328:Adult; D001652:Bile Ducts / Q000601:surgery*; D002404:Catheterization / Q000379:methods*; D003251:Constriction, Pathologic; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D016031:Liver Transplantation; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D012086:Reoperation; D016896:Treatment Outcome