Treatment of Iliofemoral Stenosis and Occlusion by Means of Modified Gianturco Expandable Metallic Stents

1994 ◽  
pp. 337-343
Author(s):  
Byung Suk Roh ◽  
See Sung Choi ◽  
Seon Kwan Juhng ◽  
Chang Guhn Kim ◽  
Jong Jin Won
Radiology ◽  
1990 ◽  
Vol 177 (3) ◽  
pp. 799-802 ◽  
Author(s):  
K Kichikawa ◽  
H Uchida ◽  
T Yoshioka ◽  
M Maeda ◽  
K Nishimine ◽  
...  

1994 ◽  
Vol 31 (1) ◽  
pp. 35 ◽  
Author(s):  
Yo Won Choi ◽  
Yong Soo Kim ◽  
Seok Chol Jeon ◽  
Chang Kok Hahm ◽  
Chul Seung Choi

2019 ◽  
Vol 12 ◽  
pp. 263177451986778 ◽  
Author(s):  
Tomazo Franzini ◽  
Vitor M.T. Sagae ◽  
Hugo G. Guedes ◽  
Paulo Sakai ◽  
Daniel R. Waisberg ◽  
...  

Background and aims: Post liver transplant biliary anastomotic strictures have traditionally been treated with balloon dilation and multiple plastic stents. Fully covered self-expandable metallic stents may be used as an initial alternative or after multiple plastic stents failure. Refractory strictures can occur in 10–22% and require revisional surgery. Alternatively, cholangioscopy allows direct visualization and therapeutic approaches. We aimed to assess the feasibility, safety, and efficacy of balloon dilation combined with cholangioscopy-guided steroid injection for the treatment of refractory anastomotic biliary strictures. Methods: Three post-orthotopic liver transplant patients who failed standard treatment of their biliary anastomotic strictures underwent endoscopic retrograde cholangiopancreatography with balloon dilation followed by cholangioscopy-guided steroid injection at a tertiary care center. Patients had follow-up with images and laboratorial tests to evaluate for residual stricture. Results: Technical success of balloon dilation + cholangioscopy-guided steroid injection was achieved in all patients. Cholangioscopy permitted accurate evaluation of bile ducts and precise localization for steroid injection. No adverse events occurred. Mean follow-up was 26 months. Two patients are stent free and remain well in follow-up, with no signs of biliary obstruction. No further therapeutic endoscopic procedures or revisional surgery were required. One patient did not respond to balloon dilation + cholangioscopy-guided steroid injection after 11 months of follow-up and required repeat balloon dilation of new strictures above the anastomosis. Conclusion: Cholangioscopy-guided steroid injection combined with balloon dilation in the treatment of refractory post liver transplant strictures is feasible and safe. This method may be used as a rescue alternative before surgical approach. Randomized controlled trials comparing balloon dilation + cholangioscopy-guided steroid injection to fully covered self-expandable metallic stents are needed to determine the role of this treatment for anastomotic biliary strictures.


2013 ◽  
Vol 1 (2) ◽  
pp. 48-51 ◽  
Author(s):  
Takayuki Takeda ◽  
Hideki Itano ◽  
Shinichi Fukita ◽  
Masahiko Saitoh ◽  
Sorou Takeda

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