Biliary Strictures in 130 Consecutive Right Lobe Living Donor Liver Transplant Recipients: Results of a Western Center

Shah, Shimul A.; Grant, David; McGilvray, Ian; Greig, Paul D.; Selzner, Markus; Lilly, Les; Girgrah, Nigel; Levy, Gary; Cattral, Mark S.

doi:10.1111/j.1600-6143.2006.01601.x

Cited by 188 publications

(176 citation statements)

References 20 publications

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“…both were HCV positive. Both of them recovered well after Reexploration and left renal vein ligation [26][27][28][29][30]. One patient had portal flow augmentation with LHA which was unsuccessful, 2 patients had cavoportal hemi-transposition of which one died the other is surviving more than 24 months.…”

Section: Portal Vein Thrombosismentioning

confidence: 89%

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When to Re-explore Recipients in LRLT

Selvakumar¹,

Nayeem²

2016

J Gastrointest Dig Syst

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Re-exploration is one of the surgical complications of living donor liver transplantations. Re-explorations are of two types planned and unplanned. Unplanned re-exploration does always mean poor prognosis to the patient outcome? Was the aim of our study? We analysed retrospectively prospectively maintained data from Jan 2011 to August 2013. Total number of transplants done was 793. Total number of re-explorations was 80 in 66 patients. Reexploration rate was 10.08%. Total mortality in our series was 10.5%. Mortality in Re-exploration group was 45.45%. Of the group of patients re-explored patients re-explored for early haemorrhage had better outcomes compared to patients explored for other reasons. Re-explored patients are at higher risk of fungal infections. Patients with multiple bile ducts are at higher risk of re-explorations. Patients re-explored in the immediate post-operative period had better outcomes compared to patients re-explored late. Overall it is a poor prognostic indicator of surgical outcome in living donor liver transplantation.

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Section: Portal Vein Thrombosismentioning

confidence: 89%

“…Immediate re-exploration and ileostomy was done and he recovered well. One patient had enteric contents in the drain [21][22][23][24][25][26]. She was managed conservatively in view of low output fistula.…”

Section: Operations Upon the Gastrointestinal Tractmentioning

confidence: 99%

When to Re-explore Recipients in LRLT

Selvakumar¹,

Nayeem²

2016

J Gastrointest Dig Syst

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“…However, results of endoscopic maneuvers are disappointing for biliary strictures after LDLT, and the success rate is 60∼75% for anastomotic strictures (1,4,6,7,11-15). The causes for the low success rates of endoscopic intervention therapy are the presence of multiple ductal anastomoses, smaller size, peripheral location, and a pouched shape of biliary anastomosis (3,6,14,16). In right hemi-liver-LDLT patients with duct-to-duct biliary reconstruction, most anastomotic biliary strictures develop in a fork-shaped or trident-shaped fashion even if the biliary system had been reconstructed in a single duct-to-duct fashion (15).…”

Section: Discussionmentioning

confidence: 99%

“…The success rates of endoscopic treatment for anastomotic strictures in LDLT are significantly lower than in DDLT at 60∼75% (3)(4)(5)(6). In failed cases, a percutaneous approach can be attempted.…”

Section: Difficult(4)mentioning

confidence: 99%

“…Despite great improvements in the surgical techniques and standardization of the method of biliary reconstruction, the biliary tract is still the most common site for postoperative complications (1). Biliary complications are more common in living donor LT (LDLT) patients than in deceased donor LT (DDLT) patients, occurring in up to 32% of LDLT patients compared to 10∼15% of patients who undergo DDLT (2,3). The non-operative management of biliary complications following LT has become standard practice with primarily endoscopic techniques as the preferred diagnostic and therapeutic modalities, obviating the need for surgery in a majority of patients.…”

Section: Introductionmentioning

confidence: 99%

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New Strategy in Cases of Failed Endoscopic Intervention of Biliary Strictures after Living Donor Liver Transplantation: Percutaneous Transhepatic Biliary Stent Insertion and Subsequent Endoscopic Treatment

Woo

Kim

Lee

et al. 2012

Korean J Transplant

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Background: In cases of endoscopic intervention treatment for biliary stricture which fail, a percutaneous approach can be subsequently attempted. However, the quality of life is lower for those patients with percutaneous transhepatic biliary drainage (PTBD) tubes than those with endoscopic retrograde biliary drainage tubes. In this study, we report the outcome of the application of percutaneous transhepatic biliary stenting (PTBS) for use in subsequent endoscopic treatment of biliary stricture after living donor liver transplantation (LDLT).Methods: Of 165 patients who underwent LDLT, 40 (24.2%) were diagnosed with anastomotic biliary strictures. Of these patients, seven agreed to treatment using PTBS using a plastic stent with endoscopic follow-up instead of treatment by insertion of a PTBD tube, and were enrolled in this study.Results: In all seven patients, the use of this technique enabled effective advancement of a guide wire and successful placement of one or two plastic stents (7 or 10 Fr) into the PTBD tract. There were no PTBS-related complications associated with the procedure. The median duration for stent use was 40.3 weeks (range; 27.6~65.0). Upon final removal of all stents, the stricture had been resolved in four (57%) of the seven patients.Conclusions: Our study data suggested that, after failed use of ERCP in the treatment of biliary stricture after LDLT, the use of PTBS and ERCP may be an effective and safe treatment.

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Liver Transplantation

Fox¹,

Brown²

2015

Yamada' S Textbook of Gastroenterology

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Biliary Strictures in 130 Consecutive Right Lobe Living Donor Liver Transplant Recipients: Results of a Western Center

Cited by 188 publications

References 20 publications

When to Re-explore Recipients in LRLT

When to Re-explore Recipients in LRLT

New Strategy in Cases of Failed Endoscopic Intervention of Biliary Strictures after Living Donor Liver Transplantation: Percutaneous Transhepatic Biliary Stent Insertion and Subsequent Endoscopic Treatment

Liver Transplantation

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