title: Endoscopic stent placement above the intact sphincter of Oddi for biliary strictures after living donor liver transplantation.
abstract: OBJECTIVE
  Biliary complications are one of the most serious morbidities after liver transplantation. Inside-stent is a plastic stent placed above the sphincter of Oddi without endoscopic sphincterotomy against biliary strictures. Our aims were to analyze the long-term efficacy of inside-stent placement in patients with biliary stricture after living donor liver transplantation.
  
  
  METHODS
  Ninety-four patients who experienced biliary stricture that employed duct-to-duct reconstruction were treated with inside-stent placement. Treatment outcomes, including stricture resolution, recurrence, inside-stent patency, and morbidity rate were evaluated retrospectively.
  
  
  RESULTS
  Ninety-two patients could be evaluated. Resolution of stricture was eventually observed in 81 of 92 patients with an average of 1.4 sessions of endoscopic retrograde cholangiography. Of the 81 patients who achieved the resolution of the stricture, recurrent biliary stricture that required intervention occurred in 8 patients. Conversely, stricture remission was achieved 73 patients (90.1 %) during 53 months follow-up after stent removal. Median duration of patency of the initial stent was 189 (range 2-1228) days. Stent dislocation occurred in 10 patients. Adverse event related to inside-stent placement was pancreatitis in 18 cases (mild 13, moderate 5).
  
  
  CONCLUSIONS
  Inside-stent placement achieved long-term patency and high remission rate in patients with biliary stricture after liver transplantation.
authors: Department of Gastroenterology and Hepatology, Kyoto University Graduate School of Medicine, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan.
authors: Akira
authors: A
authors: Kurita
authors: Yuzo
authors: Y
authors: Kodama
authors: Ryuki
authors: R
authors: Minami
authors: Yojiro
authors: Y
authors: Sakuma
authors: Katsutoshi
authors: K
authors: Kuriyama
authors: Wataru
authors: W
authors: Tanabe
authors: Yuji
authors: Y
authors: Ohta
authors: Takahisa
authors: T
authors: Maruno
authors: Masahiro
authors: M
authors: Shiokawa
authors: Yugo
authors: Y
authors: Sawai
authors: Norimitsu
authors: N
authors: Uza
authors: Shujiro
authors: S
authors: Yazumi
authors: Atsushi
authors: A
authors: Yoshizawa
authors: Shinji
authors: S
authors: Uemoto
authors: Tsutomu
authors: T
authors: Chiba
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical / Q000009:adverse effects; D002648:Child; D002779:Cholestasis / Q000209:etiology / Q000601:surgery*; D003251:Constriction, Pathologic / Q000209:etiology / Q000601:surgery; D016145:Endoscopy, Digestive System / Q000009:adverse effects / Q000379:methods; D005260:Female; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects* / Q000379:methods; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D009803:Sphincter of Oddi / Q000601:surgery; D015607:Stents; D016896:Treatment Outcome; D055815:Young Adult