Percutaneous Cholangioscope–Assisted Laser Incision of Severe Benign Hepaticojejunostomy Stenoses

Valeshabad, Ali Kord; Makramalla, Abouelmagd; Zhang, Lulu; Sriwastwa, Aakanksha; Chadalavada, Seetharam

doi:10.1016/j.jvir.2022.04.034

Cited by 3 publications

(3 citation statements)

References 4 publications

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“…Percutaneous cholangioscope-assisted laser incision has been used by our team to treat severe benign biliary stenosis. 15 The preliminary study of four patients showed that laser incision is a feasible treatment for such patients with severe biliary strictures. The patients in our study were transferred from an outside hospital with long-term biliary drains (up to 72 months) and had a history of multiple procedures in the past.…”

Section: Stepwise Management Of Severe Benign Hepaticojejunostomy Ste...mentioning

confidence: 99%

“…Only one minor biliary leak was observed without any clinical consequences. 15 In our institution, percutaneous laser incisions are performed under general anesthesia. Patients receive preprocedural antibiotics.…”

Section: Cholangioscope-assisted Laser Incisionmentioning

confidence: 99%

“…8,14 More recently, the introduction of percutaneous cholangioscope-assisted procedures has widened the range of procedures offered by interventional radiology to patients with failed conventional percutaneous approaches. [15][16][17]…”

mentioning

confidence: 99%

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Stepwise Percutaneous Approach to Treat Severe Benign Hepaticojejunostomy Stenosis

Nahab

Sriwastwa

Shelton

et al. 2022

Semin intervent Radiol

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Section: Stepwise Management Of Severe Benign Hepaticojejunostomy Ste...mentioning

confidence: 99%

Section: Cholangioscope-assisted Laser Incisionmentioning

confidence: 99%

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Stepwise Percutaneous Approach to Treat Severe Benign Hepaticojejunostomy Stenosis

Nahab

Sriwastwa

Shelton

et al. 2022

Semin intervent Radiol

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Percutaneous Endoscopy–Assisted Laser Incision of Severe Transplant Ureteral Stricture

Kord,

Byers,

Zhang

et al. 2024

Journal of Vascular and Interventional Radiology

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Biliary Complications after Liver Transplant: Imaging Review and Minimally Invasive Management

Jain,

Kumar,

Sasturkar

et al. 2024

Digestive Disease Interventions

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With the advent of living donor liver transplant, the waiting list mortality of patients needing liver transplant has decreased. However, increased morbidity is observed, including higher rates of biliary complications (BCs). Strictures and postoperative leaks constitute the majority of the BCs. Various factors such as multiple biliary ducts anastomosis and small caliber ducts in the bile ducts increase the risk of biliary strictures. The lack of biliary dilation in the graft livers after liver transplant makes the recognition of biliary complications challenging and the diagnosis relies on abnormal liver function tests. Magnetic resonance cholangiopancreaticography provides a valuable means to assess the biliary anatomy prior to interventions by showing the level of stricture. While endoscopic retrograde cholangiopancreatography is considered the first modality to treat biliary strictures, those patients with proximal strictures and those with complex biliary anatomy with acute angulations between the donor and the recipient show poor response to endoscopic interventions. In such patients, percutaneous biliary interventions have success rates between 70 and 90%. Novel percutaneous biliary intervention techniques such as cholangioscopy-assisted laser incision and magnetic compression anastomosis are used to navigate difficult biliary strictures. Recently, biodegradable stents have been used to treat recalcitrant biliary strictures. In this review, we present the imaging features of common biliary complications following liver transplant and percutaneous biliary interventions in managing these complications.

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Percutaneous Cholangioscope–Assisted Laser Incision of Severe Benign Hepaticojejunostomy Stenoses

Cited by 3 publications

References 4 publications

Stepwise Percutaneous Approach to Treat Severe Benign Hepaticojejunostomy Stenosis

Stepwise Percutaneous Approach to Treat Severe Benign Hepaticojejunostomy Stenosis

Percutaneous Endoscopy–Assisted Laser Incision of Severe Transplant Ureteral Stricture

Biliary Complications after Liver Transplant: Imaging Review and Minimally Invasive Management

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