Long-term Efficacy of Endoscopic Stenting in Patients with Stricture of the Biliary Anastomosis after Orthotopic Liver Transplantation

Rossi, Alfredo; Grosso, C.; Zanasi, G.; Gambitta, P.; Bini, Marta; Carlis, Luciano De; Rondinara, G. F.; Arcidiacono, R

doi:10.1055/s-2007-1001283

Cited by 92 publications

(74 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…2 failures of endoscopic treatment for anastomotic stricture in the present study had to undergo hepaticojejunostomy after 7 and 8 mo of OLT. Our success rate of 81% lies between 70%-100% as has been reported in previous studies [21,39,41] . The severity and number of these anastomotic strictures will increase in coming times as more and more complex biliary anastomoses are being performed (living donor, split liver transplant, etc) [42][43][44][45] , mainly because of widening gap of demand and supply of the organ.…”

Section: Discussionsupporting

confidence: 82%

“…It constituted 28 (40%) of biliary complications in our patient group and half of these presented between 4-12 mo post OLT. Use of ERC for treating anastomotic stricture in older studies had been disappointing [36,37] , however newer studies have reported the efficacy of endoscopic and percutaneous approaches in managing these complications [5,36,[38][39][40] . 2 failures of endoscopic treatment for anastomotic stricture in the present study had to undergo hepaticojejunostomy after 7 and 8 mo of OLT.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Liver biochemistry profile, significance and endoscopic management of biliary tract complications post orthotopic liver transplantation

Shastri

Hoepffner²,

Akoglu³

et al. 2007

WJG

View full text Add to dashboard Cite

AIM:To correlate the significance of liver biochemical tests in diagnosing post orthotopic liver transplantation (OLT) biliary complications and to study their profile before and after endoscopic therapy. METHODS:Patients who developed biliary complications were analysed in detail for the clinical information, laboratory tests, treatment offered, response to it, follow up and outcomes. The profile of liver enzymes was determined. The safety, efficacy and outcomes of endoscopic retrograde cholangiography (ERC) were also analysed.RESULTS: 40 patients required ERC for 70 biliary complications. GGT was found to be > 3 times (388.1 ± 70.9 U/mL vs 168.5 ± 34.2 U/L, P = 0.007) and SAP > 2 times (345.1 ± 59.1 U/L vs 152.7 ± 21.4 U/L, P = 0.003) the immediate post OLT values. Most frequent complication was isolated anastomotic strictures in 28 (40%). Sustained success was achieved in 26 (81%) patients. CONCLUSION:Biliary complications still remain an important problem post OLT. SAP and GGT can be used as early, non-invasive markers for diagnosis and also to assess the adequacy of therapy. Endoscopic management is usually effective in treating the majority of these biliary complications.

show abstract

Section: Discussionsupporting

confidence: 82%

Section: Discussionmentioning

confidence: 99%

Liver biochemistry profile, significance and endoscopic management of biliary tract complications post orthotopic liver transplantation

Shastri

Hoepffner²,

Akoglu³

et al. 2007

WJG

View full text Add to dashboard Cite

show abstract

“…Early strictures often are amenable to endoscopic or transhepatic intervention with good long-term results. 22 Recurrence of strictures is less likely if the initial dilatation is combined with a period of stenting for several months. However, after an anastomotic stricture occurs, regardless of the success of the initial treatment, patient follow-up should be vigilant.…”

Section: Early Complicationsmentioning

confidence: 99%

Management of biliary problems after liver transplantation

Möser

Wall

2001

Liver Transplantation

110

View full text Add to dashboard Cite

“…However, over the past decade there has been tremendous improvement in endoscopic techniques, making endotherapy the treatment of choice for management of these strictures [29][30][31] . PTC and surgery are less often utilized, and usually reserved for cases where ERC cannot be used or has failed.…”

Section: Biliary Stricturesmentioning

confidence: 99%

Endoscopic management of post-liver transplant biliary complications

Girotra¹,

Soota²,

Klair³

et al. 2015

WJGE

View full text Add to dashboard Cite

Biliary complications are being increasingly encountered in post liver transplant patients because of increased volume of transplants and longer survival of these recipients. Overall management of these complications may be challenging, but with advances in endoscopic techniques, majority of such patients are being dealt with by endoscopists rather than the surgeons. Our review article discusses the recent advances in endoscopic tools and techniques that have proved endoscopic retrograde cholangiography with various interventions, like sphincterotomy, bile duct dilatation, and stent placement, to be the mainstay for management of most of these complications. We also discuss the management dilemmas in patients with surgically altered anatomy, where accessing the bile duct is challenging, and the recent strides towards making this prospect a reality. Core tip: Biliary complications are being increasingly encountered in post liver transplant patients because of increased volume of transplants and longer survival of these recipients. Overall management of these complications may be challenging, but with advances in endoscopic techniques, majority of such patients are being dealt with by endoscopists rather than the surgeons. Our review article discusses the recent advances in endoscopic tools and techniques which have proved ERCP with various interventions, like sphincterotomy, bile duct dilatation, and stent placement, to be the mainstay for management of most of these complications. We also deliberate the management dilemmas in patients with surgically altered anatomy, where accessing the bile duct is challenging, and the recent strides towards making this prospect a reality.

show abstract

Long-term Efficacy of Endoscopic Stenting in Patients with Stricture of the Biliary Anastomosis after Orthotopic Liver Transplantation

Cited by 92 publications

References 0 publications

Liver biochemistry profile, significance and endoscopic management of biliary tract complications post orthotopic liver transplantation

Liver biochemistry profile, significance and endoscopic management of biliary tract complications post orthotopic liver transplantation

Management of biliary problems after liver transplantation

Endoscopic management of post-liver transplant biliary complications

Contact Info

Product

Resources

About