Endoscopic treatment in biliary strictures after pediatric liver transplantation.

Abstract:

BACKGROUND AND AIM:The aim of the study was to assess efficacy and safety of endoscopic treatment in BS after pediatric LTx. METHODS:We retrospectively reviewed data of patients with DDA who developed BS and underwent ERCP. RESULTS:Of 189 transplanted patients with DDA, strictures developed in 30 (16%). In this subgroup, the median age at LTx was 14.7 (1.5-17.6) and follow-up period was 3.9 (1.3-11.3). ABS were in 76% and NABS in combination with ABS in 24% of patients. Overall, 95 ERCP sessions (3.0 per patient) were performed with successful outcome in 22 (73%) cases. Duration of treatment was 9.1 (1.8-24.1) months. Five patients underwent surgical revision and three patients retransplantation (10%). Risk factors of endoscopy failure were HCV or HBV infection, prolonged CIT and treatment before 2007. The most common complications after ERCP were cholangitis (8.2%) and pancreatitis (4.2%). There were worse overall prognosis and higher risk of post-ERCP complications in NABS. CONCLUSIONS:ERCP is safe and effective in the majority of patients with post-transplant duct-to-duct BS, and it is currently recommended as the first-line treatment.

journal_name

Pediatr Transplant

authors

Czubkowski P,Pertkiewicz J,Markiewicz-Kijewska M,Kaliciński P,Rurarz M,Jankowska I,Pawłowska J

doi

10.1111/petr.13271

subject

Has Abstract

pub_date

2018-11-01 00:00:00

pages

e13271

issue

7

eissn

1397-3142

issn

1399-3046

journal_volume

22

pub_type

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