Transhepatic Dilatation of Choledochoenterostomy Strictures

Molnar, William; Stockum, Alfred E.

doi:10.1148/129.1.59

Cited by 91 publications

(22 citation statements)

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“…1). Balloon dilatation of postoperative biliary strictures in nontransplant patients is safe, with reported success rates of 85-89% [21,22]. Similarily, we have found the procedure to be safe and effective in transplants.…”

Section: Discussionsupporting

confidence: 73%

Percutaneous transhepatic cholangiography and biliary drainage after liver transplantation: A five-year experience

Zajko¹,

Bron²,

Campbell³

et al. 1987

Gastrointest Radiol

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Evaluation of the biliary tract by percutaneous transhepatic cholangiography (PTC) is often required in liver transplant patients with an abnormal postoperative course. Indications for PTC include failure of liver enzyme levels to return to normal postoperatively, an elevation of serum bilirubin or liver enzyme levels, suspected bile leak, biliary obstructive symptoms, cholangitis, and sepsis.Over a 5-year period 625 liver transplants in 477 patients were performed at the University Health Center of Pittsburgh. Fifty-three patients (56 transplants) underwent 70 PTCs. Complications diagnosed by PTC included biliary strictures, bile leaks, bilomas, liver abscesses, stones, and problems associated with internal biliary stents.Thirty-two percutaneous transhepatic biliary drainage procedures were performed. Ten transplantation patients underwent balloon dilatation of postoperative biliary strictures. Interventional radiologic techniques were important in treating other complications and avoiding additional surgery in many of these patients. KeywordsCholangiography; percutaneous transhepatic -Bile ducts; percutaneous drainage -Liver; transplantation Liver transplantation has now become an acceptable therapy for advanced, irreversible liver disease in both children and adults [1,2]. In patients with an abnormal posttransplantation course, a biliary tract complication is a primary diagnostic consideration. If serious biliary complications are not recognized and corrected promptly, there is no chance for the immunosuppressed liver transplant patient to survive [3].In the early postoperative period, most liver transplant patients have a T-tube in the common bile duct that permits easy examination by T-tube cholangiography [4]. However, direct access to the biliary tree via a percutaneous tube is not always available, particularly in the late postoperative period. In many such patients, percutaneous transhepatic cholangiography (PTC) is the preferred, or only, means of evaluating the biliary tree. NIH Public Access Author ManuscriptGastrointest Radiol. Author manuscript; available in PMC 2010 November 1. Published in final edited form as:Gastrointest Radiol. 1987 ; 12(2): 137-143. NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author ManuscriptA PTC procedure permits the diagnosis of a variety of posttransplant complications that may require early surgical intervention. In selected cases, percutaneous transhepatic biliary drainage (PTBD) and related interventions, such as balloon dilatation of strictures and transhepatic removal of internal stents, may be performed to avoid further complications and additional surgical procedures. In this paper, we report our experience with PTC, PTBD, and related techniques in 56 pediatric and adult liver transplants. Subjects and MethodsDuring the 5 years from January, 1981 to January, 1986 received 625 orthotopic liver transplants. One hundred and forty-eight retransplants, including both first and second retransplants (78 in adults, 70 in children), were performed. Th...

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Section: Discussionsupporting

confidence: 73%

Percutaneous transhepatic cholangiography and biliary drainage after liver transplantation: A five-year experience

Zajko¹,

Bron²,

Campbell³

et al. 1987

Gastrointest Radiol

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“…In adults, Gruntzig angioplasty balloon catheters have been used in the dilatation of narrowed blood vessels [1], bile ducts [2,3], ampulla of vater [4], biliary-enteric anastomoses [5,6], and esophageal strictures [7]. In children, there have been fewer reports of the use of Gruntzig balloons but they have been used successfully to dilate bilial3r [8] and esophageal strictures [9].…”

mentioning

confidence: 99%

Gruntzig angioplasty dilatation of an esophageal stricture in an infant

1985

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“…Molnar and Stockum [3], in 1978, first reported balloon dilatation of choledochoenterostomy strictures in 9 patients using a Teflon caged balloon catheter. More recently, Martin et al [4] reported 2 cases successfully treated using the Grfintzig balloon catheter.…”

Section: Discussionmentioning

confidence: 99%

Balloon dilatation of benign postsurgical biliary-enteric anastomotic strictures

Teplick

Wolferth

Hayes

et al. 1982

Gastrointest Radiol

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Five benign postsurgical strictures in 3 patients were successfully dilated using the Grfintzig balloon catheter. Various aspects of the procedure as well as potential problems are discussed.We concluded that, although considerably more experience is needed, balloon dilatation potentially can reduce the need for surgical repair and provide a means to remove indwelling biliary drainage catheters.Benign bile duct strictures are a direct result of previous surgery in 90-95% of cases. Most occur after biliary surgery, such as cholecystectomy with Address reprint requests to."

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Transhepatic Dilatation of Choledochoenterostomy Strictures

Cited by 91 publications

References 0 publications

Percutaneous transhepatic cholangiography and biliary drainage after liver transplantation: A five-year experience

Percutaneous transhepatic cholangiography and biliary drainage after liver transplantation: A five-year experience

Gruntzig angioplasty dilatation of an esophageal stricture in an infant

Balloon dilatation of benign postsurgical biliary-enteric anastomotic strictures

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