Abstract：
BACKGROUND AND AIMS:Biliary complications (BCs) occur in up to 40% of living donor liver transplant (LDLT) recipients. The aim of this study was to evaluate the efficacy of endoscopic therapy in the management of LDLT-related BCs. METHODS:A retrospective study of 100 LDLT recipients at a single transplant center over a 9-year period was conducted. BC was defined as a biliary leak and/or a stricture. Patient records were used to identify time to diagnosis, type of intervention, and time to resolution. RESULTS:BCs occurred in 46 (46%) patients; median follow-up was 4.6 years (range 5 days-9.3 years); and median time to diagnosis was 37.5 days (range 1 day-3.5 years). BCs were classified as a leak in 6 (6%), stricture in 22 (22%), and a leak + stricture in 18 (18%). ERCP was the initial treatment modality in 43/46 (93%) patients and was completed in 42/43 (98%). Three (6.5%) patients with a leak underwent surgery as the primary treatment approach. The median time to resolution of BCs was 91.5 days (range 21-367). Thirteen patients had a recurrence which was managed with endoscopic therapy alone. CONCLUSIONS:Endoscopic therapy was successful in almost all patients (98%) and ERCP alone resulted in successful treatment in a higher proportion of patients (93%) than traditionally reported. Advanced endoscopic techniques obviate the need for PTC and/or surgery and allow successful management in almost all LDLT recipients presenting with BC and in patients with recurrence of strictures.
journal_name
Dig Dis Scijournal_title
Digestive diseases and sciencesauthors
Elwir S,Thompson J,Amateau SK,Trikudanathan G,Attam R,Hassan M,Kandaswamy R,Pruett T,Lake J,Chinnakotla S,Freeman ML,Arain MAdoi
10.1007/s10620-016-4367-zsubject
Has Abstractpub_date
2017-01-01 00:00:00pages
244-252issue
1eissn
0163-2116issn
1573-2568pii
10.1007/s10620-016-4367-zjournal_volume
62pub_type
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