title: New endoscopic classification system for biliary stricture after liver transplantation.
abstract: OBJECTIVE
  A new classification system for biliary stricture (BS) after liver transplantation (LT) is proposed, aiming to standardize endoscopic treatment for this condition.
  
  
  METHODS
  Data were retrospectively collected from patients who had undergone endoscopic retrograde cholangiography after LT, and who provided endoscopy images clear enough to reveal the biliary system. Images were classified separately by two endoscopists, who discussed and resolved any disputed findings. From these images, a new classification system is proposed (Ling classification): type A, normal biliary structure; type B, anastomotic stricture and normal intrahepatic biliary structure; type C, narrow and stiff intrahepatic biliary structure or beaded intrahepatic biliary structure or intrahepatic biliary cast without anastomotic stricture; type D, narrow and stiff intrahepatic biliary structure or beaded intrahepatic biliary structure or intrahepatic biliary cast with anastomotic stricture.
  
  
  RESULTS
  Analysis involved 93 patients: 76 men and 17 women, median age 54 years (range, 12-69 years). Type B was the most commonly observed BS after LT, accounting for 44 cases (47.3%). Type A, the least commonly observed type, accounted for nine (9.7%), type C for 22 (23.7%) and type D for 18 (19.3%) cases.
  
  
  CONCLUSIONS
  A new endoscopic classification system for BS after LT is proposed, to help determine the most appropriate treatment for patients with each type of stricture.
authors.affiliation: Department of Gastroenterology, People's Liberation Army General Hospital, Beijing, China.
authors.forename: Zhichu
authors.initials: Z
authors.lastname: Qin
authors.forename: En-Qiang
authors.initials: EQ
authors.lastname: Linghu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001659:Biliary Tract / Q000473:pathology*; D001662:Biliary Tract Surgical Procedures; D002648:Child; D002760:Cholangiopancreatography, Endoscopic Retrograde; D002779:Cholestasis / Q000473:pathology / Q000601:surgery*; D003251:Constriction, Pathologic; D005260:Female; D006801:Humans; D041781:Jaundice, Obstructive / Q000473:pathology; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D055815:Young Adult
keywords: Liver transplantation; biliary stricture; classification; endoscopic retrograde cholangiography