title: Retained surgical stents as a cause of biliary obstruction in pediatric liver transplants.
abstract: BACKGROUND
  Small-caliber plastic stents are sometimes placed across the hepaticojejunostomy in liver transplant recipients at the time of biliary reconstruction. These stents usually pass spontaneously, but they can be retained and, rarely, this may cause biliary obstruction.
  
  
  OBJECTIVE
  The purpose of this paper is twofold: to describe the appearance of biliary tract obstruction caused by retained surgical stents in pediatric liver transplants, and to report how these stents can be removed using interventional radiology techniques.
  
  
  METHODS
  Three pediatric patients presenting with biochemical and imaging evidence of biliary obstruction were encountered over a 6-month period. At percutaneous cholangiography all patients were found to have retained surgical stents which appeared to be causing biliary tract obstruction. Percutaneous snaring of the stents was undertaken.
  
  
  RESULTS
  All stents were successfully removed using interventional radiology techniques, and follow-up showed no evidence of recurrent obstruction.
  
  
  CONCLUSIONS
  Surgical stents in children undergoing hepaticojejunostomy may be retained and cause biliary obstruction. Radiologists involved with imaging these patients should be aware of this potential cause of biliary obstruction. This complication is amenable to interventional radiology techniques with good long-term results. There is no easy endoscopic or surgical treatment option in these patients.
authors.affiliation: Department of Pediatric Radiology, Children's Hospital of Pittsburgh, 4401 Penn Ave. Floor 2, Pittsburgh, PA, 15224, USA, crowleyjj@upmc.edu.
authors.forename: John J
authors.initials: JJ
authors.lastname: Crowley
authors.forename: Albert B
authors.initials: AB
authors.lastname: Zajko
authors.forename: Charles R
authors.initials: CR
authors.lastname: Fitz
authors.forename: Kyle A
authors.initials: KA
authors.lastname: Soltys
authors.forename: Jose L
authors.initials: JL
authors.lastname: Paredes
authors.forename: Vincent V
authors.initials: VV
authors.lastname: Mattiola
mesh_terms: D000328:Adult; D002675:Child, Preschool; D002758:Cholangiography; D002779:Cholestasis / Q000000981:diagnostic imaging* / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D016031:Liver Transplantation; D008297:Male; D011183:Postoperative Complications / Q000000981:diagnostic imaging* / Q000209:etiology; D015641:Radiography, Interventional; D012189:Retrospective Studies; D015607:Stents / Q000009:adverse effects*; D055815:Young Adult