title: Percutaneous Management of Benign Biliary Strictures with Large-Bore Catheters: Comparison between Patients with and without Orthotopic Liver Transplantation.
abstract: OBJECTIVE
  To prospectively evaluate stricture resolution and patency rates of benign biliary strictures treated with percutaneous large-bore catheter "stenting" in patients with and without previous orthotopic liver transplantation (OLT) and to compare treatment outcomes between these two groups.
  
  
  METHODS
  Forty-six consecutive patients (25 with OLT) underwent percutaneous catheter placement in extrahepatic and single-site biliary stricture for 6-8 months, with progressive catheter upsizing to 18-20 F. Primary patency rate was defined as the proportion of patients without recurrent bile duct stricture during the follow-up period after successful stricture resolution. Secondary patency rate was defined as the proportion of patients with a patent bile duct at the end of follow-up after stricture resolution, including patients with stricture recurrence and successful repeat percutaneous biliary catheter treatment.
  
  
  RESULTS
  Eleven patients terminated the protocol early, 6 as a result of treatment-related reasons in the orthotopic liver transplantation (OLT) group. Sixty-four percent of the OLT group and 86.4% of control patients successfully completed the protocol, with resolved biliary strictures (P = .1) after a median treatment time of 7 months for both groups (P = .96). During mean follow-up times of 20.3 months ± 11.8 (standard deviation) and 13.1 months ± 11.73 for OLT and non-OLT patients (P = .08), respectively, the primary/secondary patency rates were comparable between groups, at 81.25%/87.5% for OLT patients and 89.5%/100% for non-OLT patients (P = .64/P = .2). The mean time to recurrent stricture was 11.2 months ± 11.88.
  
  
  CONCLUSIONS
  Percutaneous large-bore catheter treatment of benign, single-site biliary strictures showed a promising rate of stricture resolution, with comparable high primary and secondary patency rates in patients with and without previous OLT.
authors.affiliation: Division of Interventional Radiology, Department of Radiology and Biomedical Imaging Yale University School of Medicine, 330 Cedar St., TE 2-224, New Haven, CT 06510.
authors.forename: Johannes M
authors.initials: JM
authors.lastname: Ludwig
authors.affiliation: Division of Interventional Radiology and Image Guided Medicine, Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia.
authors.forename: Grant R
authors.initials: GR
authors.lastname: Webber
authors.affiliation: Duke Transplant Center, Department of Surgery, Duke University School of Medicine, Durham, North Carolina.
authors.forename: Stuart J
authors.initials: SJ
authors.lastname: Knechtle
authors.affiliation: Division of Digestive Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia.
authors.forename: James R
authors.initials: JR
authors.lastname: Spivey
authors.affiliation: Division of Interventional Radiology, Department of Radiology and Biomedical Imaging Yale University School of Medicine, 330 Cedar St., TE 2-224, New Haven, CT 06510.
authors.forename: Minzhi
authors.initials: M
authors.lastname: Xing
authors.affiliation: Division of Interventional Radiology, Department of Radiology and Biomedical Imaging Yale University School of Medicine, 330 Cedar St., TE 2-224, New Haven, CT 06510. Electronic address: kevin.kim@yale.edu.
authors.forename: Hyun S
authors.initials: HS
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002404:Catheterization / Q000379:methods*; D002779:Cholestasis / Q000628:therapy*; D003251:Constriction, Pathologic; D005260:Female; D006801:Humans; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016896:Treatment Outcome