title: The role of interventional radiology in the treatment of biliary strictures after paediatric liver transplantation.
abstract: OBJECTIVE
  The aim of this study is to evaluate the safety and efficacy of percutaneous treatment of biliary strictures after paediatric liver transplantation.
  
  
  METHODS
  In the period between October 1999 and October 2010, a total of 92 transplants in 86 children were performed at our Liver Transplant Centre. Eighteen patients had anastomotic biliary strictures (in four cases associated with intrahepatic bile duct stenosis). Percutaneous treatment (transhepatic biliary drainage and conventional/cutting balloon dilatation) was proposed as a first approach in 13/18 patients. Strict radiation protection precautions were taken in accordance with the ALARA (as low as reasonably achievable) principle. Mean follow-up time was 2,364 days.
  
  
  RESULTS
  Surgical correction was required in 3/13 patients; in 8/13 cases, there was complete disappearance of clinical symptoms without bile duct dilatation; in one case, an asymptomatic persistent bile duct dilatation was detected while in the other case, the liver is currently in cirrhotic degeneration (69 % clinical success including the asymptomatic patient with biliary dilatation). Two of the five patients who were initially treated with surgery required percutaneous revision (clinical success of 100 %). There were two cases of long-term restenosis and two cases of transient haemobilia.
  
  
  CONCLUSIONS
  Percutaneous procedures are safe and effective therapeutic options for the treatment of biliary strictures after paediatric liver transplantation.
authors.affiliation: Department of Surgical Sciences Radiology Institute, University of Torino, A.O. Città della Salute e della Scienza di Torino, Via Genova 3, Turin, 10126, Italy, paolo.fonio@unito.it.
authors.forename: Paolo
authors.initials: P
authors.lastname: Fonio
authors.forename: Marco
authors.initials: M
authors.lastname: Calandri
authors.forename: Riccardo
authors.initials: R
authors.lastname: Faletti
authors.forename: Dorico
authors.initials: D
authors.lastname: Righi
authors.forename: Alessia
authors.initials: A
authors.lastname: Cerrina
authors.forename: Andrea
authors.initials: A
authors.lastname: Brunati
authors.forename: Mauro
authors.initials: M
authors.lastname: Salizzoni
authors.forename: Giovanni
authors.initials: G
authors.lastname: Gandini
mesh_terms: D000293:Adolescent; D001659:Biliary Tract / Q000473:pathology*; D002648:Child; D002675:Child, Preschool; D002779:Cholestasis / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D003251:Constriction, Pathologic / Q000150:complications; D005260:Female; D006801:Humans; D007223:Infant; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D015642:Radiology, Interventional / Q000379:methods; D012189:Retrospective Studies; D013396:Suction / Q000379:methods; D016896:Treatment Outcome