Endoscopic treatment of pediatric post‐transplant biliary complications is safe and effective

Abstract

BC in pediatric LT were treated safely and successfully in pediatric patients when the biliary tract was accessible. The most common complications were AST, BCS and ITBL.

Endoscopic treatment in biliary strictures after pediatric liver transplantation

“…In our series, patients required a median of three interventions over the median period of 9.1 months. Dechene et al reported 11 children with ABS. Endoscopic treatment was successful in 100% with a major complication rate of 9%, and a median of four treatment sessions was required until resolution of stricture.…”

“…The most common are pancreatitis with the incidence varying between 2.7 and 12.5%, cholangitis occurring between 3.3 and 7.7% and bleeding after sphincterotomy between 1.6% and 23.5% …”

Endoscopic retrograde cholangio-pancreatography in the management of biliary complications after paediatric liver transplantation - a retrospective study

“…A similar finding was revealed by Dechene et al . in their series of seventeen patients. However, this series also reported ischaemia‐type biliary lesions and more importantly a relatively higher incidence of biliary casts.…”

“…This is more relevant in the context of not only living donor LT but also with split and technical‐variant grafts . ERCP has been shown to be a safe and effective intervention tool for both diagnosis as well as simultaneous therapeutic management of biliary complications post‐LT . Experience in children post‐LT, although described earlier, is limited and mainly from the West .…”

Resolution of post-liver transplant anastomotic biliary stricture with successful placement of a self-expanding metallic stent in a child

“…Overall, biliary complication rates following liver transplant vary from 12 % to 50 % [1], and anastomotic strictures occur in up to 10 % of patients [2]. Whereas the utility of endotherapy in the adult population is well documented, data are limited for similar interventions in the cohort of pediatric patients with liver transplants [3]. The placement of a fully covered self-expanding metal stent is an emerging modality for the treatment of refractory biliary strictures following liver transplant [4].…”