Endoscopic treatment of biliary complications after liver transplantation

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Abstract

Aim: To evaluate the of efficacy endoscopic treatment in patients who undergo OLTx or LRLTx and develop biliary complications. Methods: This is a prospective, observational study of patients who developed biliary complications, after OLTx and LRLTx, with duct-to-duct anastomosis Performed between June 2003 and June 2007. Endoscopic Retrograde Cholangiopancreatography (ERCP) was considered unsuccessful when there was evidence of continuous bile leakage despite endoscopic stent placement, or persistence of stenosis after 1 year, despite multiple dilatation and stent placement. When the ERCP failed, a percutaneous trans-hepatic approach (PTC) or surgery was adopted. Results: From June 2003 to June 2007, 261 adult patients were transplanted in our institute, 68 from living donors and 193 from cadaveric donors. In the OLTx group the rate of complications was 37.3%, while in the LRLTx group was 64.7%. The rate of ERCP failure was 19.4% in the OLTx group and 38.6% in LRLTx group. In OLTx group, 1 patient was retransplanted and 8 patients died. In the LRLTx group, 2 patients underwent OLTx and 8 patients died. The follow-up was 23.3 " 13.13 mo and 21.02 " 14.10 mo, respectively. Conclusion: Although ERCP is quite an effective mode of managing post-transplant bile duct complications, a significant number of patients need other types of approach. Further prospective studies are necessary in order to establish whether other endoscopic protocols or new devices, could improve the current results.

Original languageEnglish
Pages (from-to)4185-4189
Number of pages5
JournalWorld Journal of Gastroenterology
Volume14
Issue number26
DOIs
Publication statusPublished - 2008

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Liver Transplantation
Endoscopic Retrograde Cholangiopancreatography
Therapeutics
Stents
Prospective Studies
Living Donors
Bile Ducts
Bile
Observational Studies
Dilatation
Pathologic Constriction
Tissue Donors
Transplants
Equipment and Supplies
Liver

Keywords

  • Benign stenosis
  • Biliary complication
  • Biliary leak
  • Endoscopic retrograde cholangiopancreatography
  • Liver transplant

ASJC Scopus subject areas

  • Gastroenterology

Cite this

@article{a92627b7e68645e1a07839b9c0204f5c,
title = "Endoscopic treatment of biliary complications after liver transplantation",
abstract = "Aim: To evaluate the of efficacy endoscopic treatment in patients who undergo OLTx or LRLTx and develop biliary complications. Methods: This is a prospective, observational study of patients who developed biliary complications, after OLTx and LRLTx, with duct-to-duct anastomosis Performed between June 2003 and June 2007. Endoscopic Retrograde Cholangiopancreatography (ERCP) was considered unsuccessful when there was evidence of continuous bile leakage despite endoscopic stent placement, or persistence of stenosis after 1 year, despite multiple dilatation and stent placement. When the ERCP failed, a percutaneous trans-hepatic approach (PTC) or surgery was adopted. Results: From June 2003 to June 2007, 261 adult patients were transplanted in our institute, 68 from living donors and 193 from cadaveric donors. In the OLTx group the rate of complications was 37.3{\%}, while in the LRLTx group was 64.7{\%}. The rate of ERCP failure was 19.4{\%} in the OLTx group and 38.6{\%} in LRLTx group. In OLTx group, 1 patient was retransplanted and 8 patients died. In the LRLTx group, 2 patients underwent OLTx and 8 patients died. The follow-up was 23.3 {"} 13.13 mo and 21.02 {"} 14.10 mo, respectively. Conclusion: Although ERCP is quite an effective mode of managing post-transplant bile duct complications, a significant number of patients need other types of approach. Further prospective studies are necessary in order to establish whether other endoscopic protocols or new devices, could improve the current results.",
keywords = "Benign stenosis, Biliary complication, Biliary leak, Endoscopic retrograde cholangiopancreatography, Liver transplant",
author = "Ilaria Tarantino and Luca Barresi and Ioannis Petridis and Riccardo Volpes and Mario Traina and Bruno Gridelli",
year = "2008",
doi = "10.3748/wjg.14.4185",
language = "English",
volume = "14",
pages = "4185--4189",
journal = "World Journal of Gastroenterology",
issn = "1007-9327",
publisher = "WJG Press",
number = "26",

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T1 - Endoscopic treatment of biliary complications after liver transplantation

AU - Tarantino, Ilaria

AU - Barresi, Luca

AU - Petridis, Ioannis

AU - Volpes, Riccardo

AU - Traina, Mario

AU - Gridelli, Bruno

PY - 2008

Y1 - 2008

N2 - Aim: To evaluate the of efficacy endoscopic treatment in patients who undergo OLTx or LRLTx and develop biliary complications. Methods: This is a prospective, observational study of patients who developed biliary complications, after OLTx and LRLTx, with duct-to-duct anastomosis Performed between June 2003 and June 2007. Endoscopic Retrograde Cholangiopancreatography (ERCP) was considered unsuccessful when there was evidence of continuous bile leakage despite endoscopic stent placement, or persistence of stenosis after 1 year, despite multiple dilatation and stent placement. When the ERCP failed, a percutaneous trans-hepatic approach (PTC) or surgery was adopted. Results: From June 2003 to June 2007, 261 adult patients were transplanted in our institute, 68 from living donors and 193 from cadaveric donors. In the OLTx group the rate of complications was 37.3%, while in the LRLTx group was 64.7%. The rate of ERCP failure was 19.4% in the OLTx group and 38.6% in LRLTx group. In OLTx group, 1 patient was retransplanted and 8 patients died. In the LRLTx group, 2 patients underwent OLTx and 8 patients died. The follow-up was 23.3 " 13.13 mo and 21.02 " 14.10 mo, respectively. Conclusion: Although ERCP is quite an effective mode of managing post-transplant bile duct complications, a significant number of patients need other types of approach. Further prospective studies are necessary in order to establish whether other endoscopic protocols or new devices, could improve the current results.

AB - Aim: To evaluate the of efficacy endoscopic treatment in patients who undergo OLTx or LRLTx and develop biliary complications. Methods: This is a prospective, observational study of patients who developed biliary complications, after OLTx and LRLTx, with duct-to-duct anastomosis Performed between June 2003 and June 2007. Endoscopic Retrograde Cholangiopancreatography (ERCP) was considered unsuccessful when there was evidence of continuous bile leakage despite endoscopic stent placement, or persistence of stenosis after 1 year, despite multiple dilatation and stent placement. When the ERCP failed, a percutaneous trans-hepatic approach (PTC) or surgery was adopted. Results: From June 2003 to June 2007, 261 adult patients were transplanted in our institute, 68 from living donors and 193 from cadaveric donors. In the OLTx group the rate of complications was 37.3%, while in the LRLTx group was 64.7%. The rate of ERCP failure was 19.4% in the OLTx group and 38.6% in LRLTx group. In OLTx group, 1 patient was retransplanted and 8 patients died. In the LRLTx group, 2 patients underwent OLTx and 8 patients died. The follow-up was 23.3 " 13.13 mo and 21.02 " 14.10 mo, respectively. Conclusion: Although ERCP is quite an effective mode of managing post-transplant bile duct complications, a significant number of patients need other types of approach. Further prospective studies are necessary in order to establish whether other endoscopic protocols or new devices, could improve the current results.

KW - Benign stenosis

KW - Biliary complication

KW - Biliary leak

KW - Endoscopic retrograde cholangiopancreatography

KW - Liver transplant

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