title: Considerable Risk of Restenosis After Endoscopic Treatment for Hepaticojejunostomy Stricture After Living-Donor Liver Transplantation.
abstract: BACKGROUND
  There are few reports on the short- and long-term follow-up of endoscopic retrograde cholangiography (ERC) in adult patients with hepaticojejunostomy (HJS) stricture after living-donor liver transplantation (LDLT).
  
  
  METHODS
  Nine LDLT recipients underwent ERC with the use of double-balloon endoscopy (DBE) for HJS stricture at Nagoya University Hospital. We assessed the rate of reaching biliary anastomosis, procedure success rate, procedure duration, complications, improvement in liver function test results, and biliary anastomosis patency.
  
  
  RESULTS
  In total, 19 ERC procedures with the use of DBE were performed for 9 adult LDLT recipients with HJS stricture from June 2006 to September 2014. Balloon dilation with the use of DBE was successfully performed in 5 of the 9 patients during the 1st procedure. Of the 4 patients in whom DBE-ERC failed to be completed, 3 patients underwent 2nd procedures successfully. Liver function test results were significantly improved in the successful cases. Four patients underwent 2nd DBE-ERC for stricture recurrence at a mean time of 2.3 years after the 1st successful procedure. Of those, 2 patients required 3rd procedures for stricture recurrence after the 2nd procedure.
  
  
  CONCLUSIONS
  DBE-ERC is promising as a treatment for HJS stricture in adult LDLT recipients in the short term. However, the DBE-ERC procedure may have a considerable risk of restenosis.
authors.affiliation: Department of Transplantation Surgery, Nagoya University Hospital, Nagoya, Japan. Electronic address: kamei@med.nagoya-u.ac.jp.
authors.forename: H
authors.initials: H
authors.lastname: Kamei
authors.affiliation: Department of Transplantation Surgery, Nagoya University Hospital, Nagoya, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Imai
authors.affiliation: Department of Transplantation Surgery, Nagoya University Hospital, Nagoya, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Onishi
authors.affiliation: Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Ishihara
authors.affiliation: Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Nakamura
authors.affiliation: Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Kawashima
authors.affiliation: Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Ishigami
authors.affiliation: Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: A
authors.initials: A
authors.lastname: Ito
authors.affiliation: Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: N
authors.initials: N
authors.lastname: Ohmiya
authors.affiliation: Department of Endoscopy, Nagoya University Hospital, Nagoya, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Hirooka
authors.affiliation: Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Goto
authors.affiliation: Department of Transplantation Surgery, Nagoya University Hospital, Nagoya, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Ogura
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical / Q000009:adverse effects; D001662:Biliary Tract Surgical Procedures / Q000009:adverse effects* / Q000379:methods; D002758:Cholangiography / Q000009:adverse effects* / Q000379:methods; D003251:Constriction, Pathologic / Q000209:etiology / Q000601:surgery; D016145:Endoscopy, Digestive System; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects; D006801:Humans; D007582:Jejunostomy / Q000009:adverse effects*; D008099:Liver / Q000601:surgery; D016031:Liver Transplantation / Q000009:adverse effects* / Q000379:methods; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D055815:Young Adult