title: Interventional treatment of a biliary stricture after adult right-lobe living-donor liver transplantation with duct-to-duct anastomosis.
abstract: BACKGROUND
  [corrected] A biliary stricture is the most common complication after living-donor liver transplantation (LDLT). The present study was performed to examine treatment methods and outcomes after treatment for a biliary stricture after LDLT.
  
  
  RESULTS
  From January 2000 to December 2010, 488 patients underwent LDLT using the right lobe with duct-to-duct anastomosis at our transplantation centre. Overall biliary strictures were detected in 160 patients (32.8%), and the majority occurred within 2 years after LDLT. Biliary strictures were related to bile leakage (P < 0.001) and the urgency of the surgery (P = 0.012) in a multivariate analysis. All biliary strictures were treated with interventional modalities including an endoscopic or a percutaneous approach. Failure of interventional treatment was demonstrated in 13 patients (8.5%), among them, four (2.6%) underwent re-transplantation and nine (5.9%) died of sepsis and biliary cirrhosis during the follow-up period. A biliary stricture was not related to the survival rate (P = 0.586).
  
  
  CONCLUSIONS
  The incidence of overall biliary stricture was related to bile leakage and the urgency of the surgery. All biliary strictures could be treated by interventional modalities. These approaches are effective, complementary and help to avoid the need for surgery for a biliary stricture.
authors: Department of Surgery, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea.
authors: Gun Hyung
authors: GH
authors: Na
authors: Dong Goo
authors: DG
authors: Kim
authors: Ho Joong
authors: HJ
authors: Choi
authors: Jae Hyun
authors: JH
authors: Han
authors: Tae Ho
authors: TH
authors: Hong
authors: Young Kyoung
authors: YK
authors: You
mesh_terms: D000328:Adult; D000714:Anastomosis, Surgical; D057868:Anastomotic Leak / Q000175:diagnosis / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D001662:Biliary Tract Surgical Procedures / Q000009:adverse effects*; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000009:adverse effects / Q000401:mortality; D002779:Cholestasis / Q000175:diagnosis / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D004322:Drainage / Q000009:adverse effects / Q000401:mortality; D005260:Female; D006801:Humans; D015994:Incidence; D016031:Liver Transplantation / Q000009:adverse effects* / Q000379:methods; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
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