Endoscopic retrograde cholangiography with biliary stent placement across biliary anastomotic strictures of orthotopic liver transplantation(OLT) patients

Aims. To investigate the effect of biliary stent placement without endoscopic sphincterotomy (EST) on common bile duct stones (CBDS) disappearance and the contribution of preserving the duodenal papilla function to reduce recurrence of CBDS.Methods. Sixty-six patients admitted for acute obstructive cholangitis due to CBDS who underwent biliary stent placement without EST for 2 years from March 2011 were evaluated retrospectively. The second endoscopic retrograde cholangiopancreatography (ERCP) was performed for treatment of CBDS 3 to 4 months after the first ERCP. We estimated the rate of stone disappearance at the time of second ERCP.Results. CBDS disappearance was observed in 32 (48.5%) of 66 patients. The diameter of the bile ducts and the diameter of CBDS in patients with CBDS disappearance were significantly smaller than in those with CBDS requiring extraction (p=0.007andp<0.001, resp.). Stone disappearance was evident when the diameter of bile ducts and that of CBDS were <10 and 7 mm, respectively (p=0.002).Conclusions. Short-term stent placement without EST eliminates CBDS while preserving duodenal papilla function and may be suitable for treating CBDS in patients with nondilated bile ducts and small CBDS.

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The Efficacy and Safety of Endoscopic Balloon Dilation Combined with Stenting in Patients with Biliary Anastomotic Strictures After Orthotopic Liver Transplantation

Cell Biochemistry and Biophysics ◽

10.1007/s12013-014-0473-8 ◽

2015 ◽

Vol 72 (2) ◽

pp. 385-397 ◽

Cited By ~ 3

Author(s):

Chunyan Peng ◽

Chao Ma ◽

Guifang Xu ◽

Shanshan Shen ◽

Ying Lv ◽

...

Keyword(s):

Liver Transplantation ◽

Orthotopic Liver Transplantation ◽

Balloon Dilation ◽

Efficacy And Safety ◽

Endoscopic Balloon Dilation ◽

Anastomotic Strictures ◽

Endoscopic Balloon

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Double-balloon endoscopic retrograde cholangiography can make a reliable diagnosis and good prognosis for postoperative complications of congenital biliary dilatation

Scientific Reports ◽

10.1038/s41598-021-90550-7 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Chiyoe Shirota ◽

Hiroki Kawashima ◽

Takahisa Tainaka ◽

Wataru Sumida ◽

Kazuki Yokota ◽

...

Keyword(s):

Bile Duct ◽

Postoperative Complications ◽

Radical Surgery ◽

Endoscopic Retrograde Cholangiography ◽

Endoscopic Retrograde ◽

Congenital Biliary Dilatation ◽

Intrahepatic Stones ◽

Biliary Dilatation ◽

Double Balloon ◽

Anastomotic Strictures

AbstractBile duct and anastomotic strictures and intrahepatic stones are common postoperative complications of congenital biliary dilatation (CBD). We performed double-balloon endoscopic retrograde cholangiography (DBERC) for diagnostic and therapeutic purposes after radical surgery. We focused on the effectiveness of DBERC for the treatment of postoperative complications of CBD patients. Bile duct and anastomotic strictures and intrahepatic stones are common postoperative complications of congenital biliary dilatation (CBD). We performed double-balloon endoscopic retrograde cholangiography (DBERC) for diagnostic and therapeutic purposes after radical surgery. We focused on the effectiveness of DBERC for the treatment of postoperative complications of CBD patients. This retrospective study included 28 patients who underwent DBERC (44 procedures) after radical surgery for CBD between January 2011 and December 2019. Strictures were diagnosed as “bile duct strictures” if endoscopy confirmed the presence of bile duct mucosa between the stenotic and anastomotic regions, and as “anastomotic strictures” if the mucosa was absent. The median patient age was 4 (range 0–67) years at the time of primary surgery for CBD and 27.5 (range 8–76) years at the time of DBERC. All anastomotic strictures could be treated with only by 1–2 courses of balloon dilatation of DBERC, while many bile duct strictures (41.2%) needed ≥ 3 treatments, especially those who underwent operative bile duct plasty as the first treatment (83.3%). Although the study was limited by the short follow-up period after DBERC treatment, DBERC is recommended as the first-line treatment for hepatolithiasis associated with biliary and anastomotic strictures in CBD patients, and it can be safely performed multiple times.

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