scholarly journals Evaluation of the efficacy and reproducibility of cholangiopancreatography by magnetic resonance for detecting biliary complications following orthotopic liver transplantation

2010 ◽  
Vol 25 (3) ◽  
pp. 249-256 ◽  
Author(s):  
Marcelo Moura Linhares ◽  
Rafael Darahen de Souza Coelho ◽  
Jacob Szejnfeld ◽  
Susan Menasce Goldman ◽  
Adriano Miziara Gonzalez ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Magnetic Resonance ◽  
Orthotopic Liver Transplantation ◽  
Predictive Value ◽  
Magnetic Resonance Cholangiopancreatography ◽  
Biliary Tree ◽  
Biliary Complications ◽  
Anastomotic Strictures ◽  
Biliary Anastomosis ◽  
Tree Visualization

PURPOSE: To evaluate the accuracy and reproducibility of magnetic resonance cholangiopancreatography (MRCP) in the detection of biliary complications in liver transplanted patients. METHODS: A study was conducted, with blinded review of 28 MRCP exams of 24 patients submitted to liver transplantation. The images were reviewed by two independent observers, at two different moments, regarding the degree of biliary tree visualization and the presence or absence of biliary complications. The MRCP results were compared, when negative, to at least 3 months of clinical and biochemical follow-up, and when positive, to the findings at surgery or endoscopic retrograde cholangiopancreatography (ERCP). RESULTS: The degree of intrahepatic biliary tree visualization was considered good or excellent in 78.6% and 82.1% of the exams by the two observers and visualization of the donor duct, recipient duct and biliary anastomosis was considered good or excellent in 100% of the exams, by both observers. Six biliary complications were detected (21.4%), all of them anastomotic strictures. Intra and interobserver agreement were substantial or almost perfect (kappa k values of 0.611 to 0.804) for the visualization of the biliary tree and almost perfect (k values of 0.900 to 1.000) for the detection of biliary complications. MRCP achieved 100% sensitivity, 95.45% specificity, 85.7% positive predictive value and 100% negative predictive value for the detection of biliary complications. CONCLUSIONS: MRCP is an accurate examination for the detection of biliary complications after orthotopic liver transplantation and it is a highly reproducible method in the evaluation of the biliary tree of liver transplanted patients.

scholarly journals The Role of Endoscopy in the Treatment of Biliary Complications after Orthotopic Liver Transplantation

2019 ◽  
Vol 29 (1) ◽  
pp. 62-67
Author(s):  
Alexey V. Kurenkov ◽  
Yury S. Teterin ◽  
Oleg D. Olisov ◽  
Petr A. Yartsev ◽  
Murad S. Novruzbekov ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Orthotopic Liver Transplantation ◽  
Endoscopic Treatment ◽  
Biliary Complications ◽  
Long Term Results ◽  
Biliary Strictures ◽  
Anastomotic Strictures ◽  
Invasive Method ◽  
Nasobiliary Drainage

Aim:to improve the results of treating patients with anastomotic biliary strictures of the bile ducts after orthotopic liver transplantation.Materials and methods.This study is based on the results of the endoscopic treatment of 36 patients with biliary complications after orthotopic liver transplantation, who were admitted to the N.V. Sklifosovsky Research Institute for Emergency Medicine from December 2001 to December 2017. The endoscopic treatment program included diagnostic ERCP, endoscopic papillosphincterotomy (EPST), bilioduodenal stenting, nasobiliary drainage, balloon dilatation.Results.Against the background of the staged endoscopic treatment, the stable remission of anastomotic biliary strictures (ABS) was achieved in 17 (53.1 %) patients, with 4 of them (12.5 %) showing a successfully resolved insufficiency of biliobiliary anastomosis (BBA). The average duration of endoscopic treatment was 12 ± 1.9 months. The number of ERCPs performed for each patient varied from 1 to 12 and averaged 3. In the majority of patients (75 %) who received one or more courses of endoscopic treatment, a successful correction of anastomotic strictures with no recurrence within 2–5 years was achieved.Conclusion.Staged endoscopic treatment is established to be highly effective in patients with anastomotic biliary strictures and the insufficiency of bilobiliary anastomoses occurred after orthotopic liver transplantation. Such a treatment allows good long-term results to be achieved by a minimally invasive method.

The Role of Magnetic Resonance Cholangiopancreatography in the Diagnosis of Choledocholithiasis: Do Benefits Outweigh the Costs?

2015 ◽  
Vol 81 (7) ◽  
pp. 720-725 ◽  
Author(s):  
William H. Ward ◽  
Laura M. Fluke ◽  
Benjamin D. Hoagland ◽  
Gregory J. Zarow ◽  
Jenny M. Held ◽  
...  
Keyword(s):  
Bile Duct ◽  
Magnetic Resonance ◽  
Length Of Stay ◽  
Common Bile Duct ◽  
Predictive Value ◽  
Demographic Data ◽  
Common Bile Duct Stones ◽  
Magnetic Resonance Cholangiopancreatography ◽  
Biliary Tree ◽  
Bile Duct Stones

Endoscopic retrograde cholangiopancreatography (ERCP) is the gold standard in evaluation of the biliary tree for choledocholithiasis. Formal indications for magnetic resonance cholangiopancreatography (MRCP) in suspected choledocholithiasis are lacking. Our objective was to determine if MRCP affects management of patients who otherwise would undergo ERCP. A review was conducted of all MRCPs and ERCPs at our institution from 2008 to 2012 with suspected choledocholithiasis. Patients who underwent MRCP and ERCP were compared with those who underwent ERCP alone. Demographic data were collected and notation of whether a post-MRCP ERCP occurred was the primary variable. MRCP was performed in 107 patients for choledocholithiasis. Eighty-eight patients were negative for choledocholithiasis (82%) and 76 were discharged without ERCP (71%). Thirty-one patients received a diagnosis of choledocholithiasis and were referred for ERCP. Of the 19 patients with MRCP-diagnosed common bile duct stones, 95 per cent were confirmed by ERCP (odds ratio 18.0, P > 0.05; agreement 77%, sensitivity 0.76, specificity 0.86, positive predictive value 0.95, negative predictive value 0.50). Length of stay was similar for all groups. A total of 131 patients underwent ERCP without a preprocedural MRCP. Choledocholithiasis was found in 116 patients (92%), whereas 12 patients (9%) had no common bile duct stones and three had an alternate diagnosis. In conclusion, MRCP significantly affected the management of patients who would have undergone ERCP. MRCP did not increase length of stay and contributed to the 95 per cent positivity rate of subsequent ERCPs. These data illustrate the utility of MRCP in suspected choledocholithiasis patients at a low cost with regard to risk and time.

Role of magnetic resonance cholangiography in biliary complications of orthotopic liver transplantation

2010 ◽  
Vol 115 (7) ◽  
pp. 1065-1079 ◽  
Author(s):  
A. Pecchi ◽  
M. De Santis ◽  
F. Di Benedetto ◽  
M. Gibertini ◽  
G. Gerunda ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Magnetic Resonance ◽  
Orthotopic Liver Transplantation ◽  
Biliary Complications ◽  
Magnetic Resonance Cholangiography

scholarly journals The first experience with the fully-covered self-expandable nitinol stents in the management of anastomotic biliary strictures after orthotopic liver transplantation

2020 ◽  
Vol 48 (3) ◽  
pp. 171-176
Author(s):  
A. V. Shabunin ◽  
I. Yu. Korzheva ◽  
G. M. Chechenin ◽  
S. S. Lebedev ◽  
P. A. Drozdov ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Orthotopic Liver Transplantation ◽  
Graft Loss ◽  
Endoscopic Stenting ◽  
Biliary Strictures ◽  
Anastomotic Strictures ◽  
Nitinol Stents ◽  
Biliary Anastomosis

Background: Biliary anastomosis strictures after orthotopic liver transplantation (OLT) develop in 5–12% of patients. This complication significantly impairs the patients’ quality of life and can lead to graft loss.Aim: To analyze the first experience in the use of coated self-expanding nitinol stents in patients with biliary anastomosis strictures after OLT.Materials and methods: From December 2018 to January 2019, there were 5 patients with anastomotic strictures after OLT in the Department of Organ and/or Tissue Transplantation of the S.P. Botkin Municipal Clinical Hospital. All patients underwent endoscopic stenting of strictures with a self-expanding nitinol-coated stent. In all patients, the stent was removed at 3 months after its placement.Results: No complications and deaths were recorded in this patient group. The median duration of the follow-up after stent removal was 14.15 ± 2.35 (3–17) months, with no cases of restenosis identified.Conclusion: The use of coated nitinol stents in the management of patients with anastomotic strictures after liver transplantation is effective and safe. The possibility of their use in routine clinical practice requires confirmation in further studies.

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