Outcome of hepaticojejunostomy for biliary tract obstruction following liver transplantation

Abstract

HJS did prevent recurrent biliary obstruction in the majority of the patients. We therefore recommend early HJS for complicated post-transplant biliary tract obstruction not treatable by a limited number of endoscopic interventions.

Longterm outcome of rendezvous technique for hepaticojejunal anastomotic obstruction after pediatric living donor liver transplantation

“…Two episodes of HJO recurrence occurred after the PTBD tube was pulled out of the IHBD in case 2. We hypothesized that the cause of recurrence in the case 2 patient was mispenetration (1) and the short-term placement of a PTBD tube. (2) During the first treatment, the contrast agent was administered to the Roux-en-Y limb under direct vision with DBE to image the precise anastomosis site using fluoroscopy.…”

“…HJO after liver transplantation (LT) is a rare biliary complication, (1,2) and intractable HJO can lead to severe complications, including graft failure.…”

Endoscopic versus surgical management of biliary complications – Outcome analysis after 1188 orthotopic liver transplantations

“…For anastomotic strictures and non-anastomotic strictures hepaticojejunostomy was performed in an end-to-end or end-to-side fashion at the surgeons discretion as described before [15].…”

“…With endoscopy biliary leaks can be sealed by bile-duct stenting, anastomotic strictures are treated by dilatation and temporary stent placement, nonanastomotic strictures are treated by stents, stones or debris can be removed in many patients [13]. Nevertheless in some cases ERCP might not result in a definitive treatment for patients presenting with biliary concrements or strictures [14][15][16] resulting in multiple endoscopic re-interventions. Furthermore, long-term follow-up data on outcomes and complications after ERCP in liver transplant patients is scarce [17].…”

Biliary Complications After Liver Transplantation

“…8). Limitations of this technique include the time requirement (1-2 hours) and the relatively narrow scale of accessories (Langer et al, 2009;Mönkenmüller et al, 2008).…”