Can ultrasonography differentiate anastomotic and non-anastomotic biliary strictures after orthotopic liver transplantation- a single‐center experience

Abstract

To evaluate the role of ultrasonography (US) in differentiating anastomotic biliary strictures (AS) and non-anastomotic biliary strictures (NAS) after orthotopic liver transplantation (OLT). Method: This retrospective study included 1259 OLT recipients between 2005− 2018. Seventy-six with anastomotic strictures (AS) and 103 with non-anastomotic strictures (NAS) were analyzed. The reference standard was cholangiography. The sensitivity, specificity, accuracy of US was evaluated. Results: There were significant differences between AS and NAS groups (p < 0.001) for skipped and irregular dilatation of intrahepatic bile duct and visualization of hilar biliary lumen. The better US imaging feature for NAS was poorly visualized and non-visible hilar bile duct luminal contour. The sensitivity, specificity and accuracy were 94.2 %, 84.2 % and 88.9 % respectively. Combined two predictors greatly increased the specificity to 93.4 % while diminished its sensitivity and accuracy. Conclusion: US is useful and efficient to differentiate AS and NAS after OLT.

The role of sequential normothermic regional perfusion and end‐ischemic normothermic machine perfusion in liver transplantation from very extended uncontrolled donation after cardiocirculatory death

“…The ultrasound showed mild bile ducts dilatation containing hyperecogenic material with distinct, smooth and regular luminal contour (Figure 3E). 26 The patients underwent percutaneous biliary placement confirming the diagnosis of anastomotic structure (Figure 3F). He is currently doing well with no evidence of IC 5 months after LT, his last lab values showed bilirubin 1.3 mg/dl with normal transaminases (Figure 2H).…”

Diagnosis and Management of Biliary Strictures after Deceased-Donor Liver Transplantation Based on Clinical Practice

“…The US Characteristics of biliary strictures include biliary dilation, irregularity, discontinuity. Typical US appearance of AS is continuous, regular smooth dilation in the intrahepatic biliary duct, which is distinct from NAS [12]. Abdominal ultrasound has an approximately 100% of sensitivity in testing dilatation and obstruction of intrahepatic bile duct, however it's capacity to detect the masses and strictures is very low [13].…”

“…Some patients are asymptomatic and are identified with elevation of liver enzymes (for example ALT, AST, alkaline phosphatase), rise of bilirubin. 106 Surgical Science dilated central ducts [12].…”

Intraoperative Doppler Ultrasound for Detection of Early Postoperative Vascular Complications in Orthotopic Liver Transplants

“…Liao et al reported that assessment of the bile duct with ultrasound (US) at the hilum showing a diminished or absent bile duct lumen had a sensitivity of 94% and a specificity of 84% for non-anastomotic stricture when compared to cholangiography. Many cases of non-anastomotic stricture and anastomotic strictures are from concomitant HAS [ 29 ].…”