One-step percutaneous transhepatic cholangioscopy combined with high-frequency needle-knife electrotomy in biliary strictures after liver transplantation

Abstract Background Endoscopic management is the mainstay for biliary strictures after liver transplantation. However, this method is often failed in cases associated with hepatolithiasis or refractory strictures. The aim of this study is to investigate whether one-step PTC combined with high-frequency needle-knife electrotomy can be an alternative method in biliary strictures after liver transplantation that could not be treated by endoscopic management. Methods Clinical data of 14 patients suffering from biliary strictures after liver transplantation from June 2014 to January 2018 were retrospectively analyzed. One-step PTC combined with high-frequency needle-knife electrotomy was used to resolve the strictures. Results One-step PTC was successfully performed in all 14 patients. In 10 of 12 (83.3%) patients with hepatolithiasis, the stones were removed completely. The stricture resolution was achieved in 13 of 14 (92.9%) patients at supporting catheter removal. Three mild adverse events occurred (cholangitis, 2 patient; delayed hemobilia, 1 patient), but were resolved with conservative treatment. The follow up after supporting catheter removal was 15.7 ± 4.5 months. Only 1 patient (8.3%) had stone recurrence and no stenosis occurred during supporting-free follow-up. Conclusion One-step PTC combined with high-frequency needle-knife electrotomy appears to be a useful for treating biliary strictures after liver transplantation.

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One-step Percutaneous Transhepatic Cholangioscopy Combined With High-frequency Needle-knife Electrotomy in Biliary Strictures After Liver Transplantation

Surgical Laparoscopy, Endoscopy & Percutaneous Techniques ◽

10.1097/sle.0000000000000946 ◽

2021 ◽

Vol Publish Ahead of Print ◽

Author(s):

Haisu Tao ◽

Ping Wang ◽

Beiwang Sun ◽

Xinghua Zhou ◽

Jiafen Xie

Keyword(s):

Liver Transplantation ◽

High Frequency ◽

Biliary Strictures ◽

One Step ◽

Percutaneous Transhepatic Cholangioscopy ◽

Needle Knife

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Endoscopic Management of Biliary Complications following Liver Transplantation after Donation from Cardiac Death Donors

Canadian Journal of Gastroenterology ◽

10.1155/2012/346286 ◽

2012 ◽

Vol 26 (9) ◽

pp. 607-610 ◽

Cited By ~ 19

Author(s):

Kris P Croome ◽

Vivian McAlister ◽

Paul Adams ◽

Paul Marotta ◽

William Wall ◽

...

Keyword(s):

Liver Transplantation ◽

Liver Transplant ◽

Cardiac Death ◽

Hepatic Duct ◽

Biliary Complications ◽

Endoscopic Management ◽

Transplant Recipients ◽

Biliary Strictures ◽

Liver Transplants ◽

Liver Transplant Recipients

BACKGROUND Previous studies have shown a higher incidence of biliary complications following donation after cardiac death (DCD) liver transplantation compared with donation after brain death (DBD) liver transplantation. The endoscopic management of ischemic type biliary strictures in patients who have undergone DCD liver transplants needs to be characterized further.METHODS: A retrospective institutional review of all patients who underwent DCD liver transplant from January 2006 to September 2011 was performed. These patients were compared with all patients who underwent DBD liver transplantation in the same time period. A descriptive analysis of all DCD patients who developed biliary complications and their subsequent endoscopic management was also performed.RESULTS: Of the 36 patients who received DCD liver transplants, 25% developed biliary complications compared with 13% of patients who received DBD liver transplants (P=0.062). All DCD allograft recipients who developed biliary complications became symptomatic within three months of transplantation. Ischemic type biliary strictures in DCD allograft recipients included disseminated biliary strictures in two patients, biliary strictures of the hepatic duct bifurcation in three patients and biliary strictures of the donor common hepatic duct in three patients.CONCLUSIONS: There was a trend toward increasing incidence of total biliary complications in recipients of DCD liver allografts compared with those receiving DBD livers, and the rate of diffuse ischemic cholangiopathy was significantly higher. Focal ischemic type biliary strictures can be treated effectively in DCD liver transplant recipients with favourable results. Diffuse ischemic type biliary strictures in DCD liver transplant recipients ultimately requires retransplantation.

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Endoscopic Management of Biliary Strictures After Living Donor Liver Transplantation in Adults

Gastrointestinal Endoscopy ◽

10.1016/j.gie.2006.03.819 ◽

2006 ◽

Vol 63 (5) ◽

pp. AB306

Author(s):

Jimin Han ◽

Sung Koo Lee ◽

Jong Cheol Kim Kim ◽

Eun Kwang Choi ◽

Dong Wan Seo ◽

...

Keyword(s):

Liver Transplantation ◽

Living Donor ◽

Living Donor Liver Transplantation ◽

Endoscopic Management ◽

Biliary Strictures ◽

Donor Liver ◽

Donor Liver Transplantation

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ENDOSCOPIC MANAGEMENT OF ANASTOMOTIC BILIARY STRICTURES AFTER LIVER TRANSPLANTATION: LONG-TERM RESULTS OF A PROSPECTIVE STUDY

Digestive and Liver Disease ◽

10.1016/s1590-8658(09)60027-x ◽

2009 ◽

Vol 41 ◽

pp. S11

Author(s):

P. Cognein ◽

L. Caserta ◽

M.C. Parodi

Keyword(s):

Liver Transplantation ◽

Prospective Study ◽

Long Term Results ◽

Endoscopic Management ◽

Biliary Strictures ◽

A Prospective Study

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97 BILIARY STRICTURES AND RECURRENT DISEASE AFTER LIVER TRANSPLANTATION FOR PRIMARY SCLEROSING CHOLANGITIS – A LARGE, MULTICENTER COHORT ANALYSIS WITH LONG-TERM FOLLOW-UP

Journal of Hepatology ◽

10.1016/s0168-8278(13)60099-9 ◽

2013 ◽

Vol 58 ◽

pp. S42-S43

Author(s):

T. Horn ◽

N. Pannicke ◽

A. Dechene ◽

D. Gotthardt ◽

G. Kirchner ◽

...

Keyword(s):

Liver Transplantation ◽

Primary Sclerosing Cholangitis ◽

Sclerosing Cholangitis ◽

Recurrent Disease ◽

Cohort Analysis ◽

Biliary Strictures ◽

Multicenter Cohort ◽

Long Term Follow Up

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Surgical Treatment of Biliary Strictures after Liver Transplantation: A Single Center Experiences

Journal of Clinical Cases & Reports ◽

10.46619/joccr.2020.3-1065 ◽

2020 ◽

Vol 3 (3) ◽

pp. 69-74

Author(s):

Ertugrul Gokhan ◽

◽

Yanaral Tumay ◽

Keyword(s):

Liver Transplantation ◽

Surgical Treatment ◽

Postoperative Morbidity ◽

Biliary Stricture ◽

Biliary Strictures ◽

Donor Liver Transplantation ◽

Common Causes ◽

End Stage ◽

Transhepatic Biliary Drainage

Aim: Liver transplantation is the only treatment for end-stage liver disease. Biliary tract pathologies that develop after liver transplantation are the most common causes of morbidity. The aim of this retrospective study was to evaluate the outcomes of surgical treatment for biliary strictures. Patients and Methods: In this study, only surgical treatment applied biliary strictures were evaluated. Between April 2014 and April 2018 at Medipol University Medical Faculty Hospital Organ Transplantation Department, Istanbul, Turkey, 129 patients with living donor liver transplantation were studied retrospectively. Results: Seven patients (5.4%) were done surgical treatment, because all percutaneous transhepatic biliary drainage (PTBD) has failed. In these patients, no exhibited postoperative morbidity, mortality and recurrence of biliary strictures in follow up 35 months. Conclusions: Surgical treatment appears to be successful in when PTBD have failed biliary stricture patients, after liver transplantation.

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