A New Biodegradable Stent to Improve the Management of Biliary Strictures in Pediatric Split Liver Transplantation

Marra, Paolo; Carbone, Francesco; Dulcetta, Ludovico; Bonaffini, Pietro Andrea; Muglia, Riccardo; D’Antiga, Lorenzo; Sironi, Sandro

doi:10.1007/s00270-022-03083-5

Cited by 4 publications

(8 citation statements)

References 7 publications

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“…There are different stent types: a tube-like model (ELLA-CS DV biliary stent; Hradec Králové, Czech Republic) 29 30 and a double-helical design (ARCHIMEDES biliary stent; AMG, Winsen, Germany). 31 Due to the helical design of the latter model, which fills the lumen of the biliary duct, a simultaneous placement of a PTBD is not possible. For the tube-like model, an additional 4-Fr PTBD was placed in one study for 2 weeks.…”

Section: Methodsmentioning

confidence: 99%

“…Stents are implanted through an 11-Fr sheath over a 0.035-inch guide wire (Cook Medical, Bloomington, both models 29 30 31 ; Fig. 5a, b ).…”

Section: Methodsmentioning

confidence: 99%

“…For the tube-like model, an additional 4-Fr PTBD was placed in one study for 2 weeks. 30 Stents are implanted through an 11-Fr sheath over a 0.035-inch guide wire (Cook Medical, Bloomington, both models [29][30][31] ; ►Fig. 5a, b).…”

Section: Pta and Stents For Stricturesmentioning

confidence: 99%

“…8 In the few case series and case reports, biodegradable stent placement after balloon angioplasty was nearly always successful with only one dislocation reported (1/6 patients, 16.6%). 31 Patency rates are high (75-100%) with a maximum follow-up of 20 months. [29][30][31] PTBD for Leaks Doppler et al described 10 children with biliary leaks after liver transplantation and subsequent PTBD placement.…”

Section: Outcomes and Complications Ptbd/pta For Stricturesmentioning

confidence: 99%

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Percutaneous Biliary Interventions in Pediatric Patients

Vogt,

Hammer,

Grözinger

et al. 2024

Digestive Disease Interventions

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Percutaneous biliary interventions have become standard for a variety of indications in pediatric patients. They offer a minimally invasive approach to managing biliary pathologies often associated with liver transplantation and hepatobiliary surgery. Interventions include the insertion of drainage catheters for bilomas, percutaneous transhepatic cholangiography for diagnostic purposes, and percutaneous transhepatic biliary drainage for the treatment of biliary leaks and cholestasis. Sonography, computed tomography, and fluoroscopy are used to guide the procedures. This review aims to demonstrate the indications and technical aspects of percutaneous biliary interventions in pediatric patients with a special focus on radiation protection.

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Section: Methodsmentioning

confidence: 99%

“…Stents are implanted through an 11-Fr sheath over a 0.035-inch guide wire (Cook Medical, Bloomington, both models 29 30 31 ; Fig. 5a, b ).…”

Section: Methodsmentioning

confidence: 99%

Section: Pta and Stents For Stricturesmentioning

confidence: 99%

Section: Outcomes and Complications Ptbd/pta For Stricturesmentioning

confidence: 99%

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Percutaneous Biliary Interventions in Pediatric Patients

Vogt,

Hammer,

Grözinger

et al. 2024

Digestive Disease Interventions

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show abstract

“…Further prospective studies are required in this field. The use of biodegradable devices has two fundamental advantages: the first is the complete reabsorption which is particularly appreciated by the interventional radiologists since it avoids the need for a delayed PTC approach for stent removal, minimizing the risk of complications; moreover, they can be used as an alternative to longterm internal-external biliary drainages, burdened by the infectious risk and device discomfort, especially in pediatric patients (12). The interventional radiological management of post-liver transplant benign biliary strictures has not been standardized yet.…”

mentioning

confidence: 99%

Developments in diagnosis and management of post-liver transplantation biliary complications: the radiologist’s perspective

Marra

Bonaffini

Ippolito

et al. 2022

Hepatobiliary Surg Nutr

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Less is more: The use of single biodegradable stenting to treat biliary anastomotic strictures in pediatric liver transplantation

Quintero Bernabeu,

Juamperez Goñi,

Mercadal Hally

et al. 2024

Liver Transplantation

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Objective : To report our experience of using biodegradable biliary stents for anastomotic biliary strictures in pediatric liver transplant patients. Methods: Analysis of a retrospective data collection from January 2014 to January 2023, including all pediatric liver transplant recipients in our center treated for anastomotic biliary strictures with biodegradable biliary stents (BBS). In phase 1 (2014-2019), there was an initial percutaneous transhepatic cholangiography (PTC) with anastomotic dilatation followed two weeks after by a second PTC with BBS insertion. In phase 2 (2019-2023), the BDS were placed shortly after anastomotic biliary strictures dilatation, requiring only one PTC. All patients were followed up with routine tests and ultrasound. Results: Forty-six anastomotic biliary strictures were diagnosed in 43 pediatric liver transplant recipients with a median of 6.7 months post-liver transplantation (0.1-246.8 months). Eight out of 46 anastomotic biliary strictures (17.4%) treated with biodegradable biliary stents relapsed (median recurrence time: 6.5 months; 1.6-17.0 months). Four resolved with further BBS placement; only four needed surgical revision (8.7%) after a median follow-up time of 43.9 months (0.3-106.3). There were no differences in anastomotic biliary strictures recurrence rate, time between stent placement and recurrence, or the presence of cholangitis based on whether the BBS was deployed in one or two steps. Patients with end-to-end anastomosis had a higher anastomotic biliary strictures recurrence (or 10.8; 1.4-81.3, p=0.008) than those with bilioenteric anastomosis. Conclusion: The use of biodegradable stents stents could be good option for treating anastomotic biliary strictures in pediatric liver transplant patients, with our series showing a success rate of over 90% and an average follow-up of 43.9 months.

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A New Biodegradable Stent to Improve the Management of Biliary Strictures in Pediatric Split Liver Transplantation

Cited by 4 publications

References 7 publications

Percutaneous Biliary Interventions in Pediatric Patients

Percutaneous Biliary Interventions in Pediatric Patients

Developments in diagnosis and management of post-liver transplantation biliary complications: the radiologist’s perspective

Less is more: The use of single biodegradable stenting to treat biliary anastomotic strictures in pediatric liver transplantation

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