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Endoscopic treatment of bile duct complications after orthotopic liver transplantation.

Abstract：

AIM:To assess the indications and results of endoscopic retrograde cholangio-pancreatography (ERCP) in patients who have undergone ortotopic liver transplantation (OLT). METHODS:We reviewed data from 42 consecutive patients who underwent ERCP for biliary complications after OLT over an 8-year period, in particular recording indications and success of the treatment after a mean of 17 months follow-up. RESULTS:Cholangiograms performed in 33/42 patients (79%) displayed anastomotic strictures in 17 patients (52%), bile duct stones in 8 (24%), both bile duct stones and an anastomotic stricture in 2 (6%), papillary stenosis in 1 (3%), and anastomotic biliary leakage in 1 (3%). In contrast, the contrastogram was normal in four patients (12%). Stone extraction was completed in 9/10 patients (90%) with a mean of 1.2 sessions, while stricture dilation was achieved in 12/19 patients (63%) after a mean of 1.7 sessions, by stent positioning (n = 7), balloon dilation (n = 4), or Soehendra dilator (n = 1). Both biliary leakage and papillary stenosis were cured by ERCP. Only one procedure-related complication -- severe pancreatitis (2.4%) -- was observed and no mortality. CONCLUSION:ERCP is a safe and effective mode of management of bile duct complications after OLT. It should be attempted before a surgical approach. Better results are obtained for treatment of biliary stones than of anastomotic strictures.

journal_name

Transplant Proc

journal_title

Transplantation proceedings

authors

Polese L,Cillo U,Brolese A,Boccagni P,Neri D,Bassi D,Erroi F,Zanus G,D'Amico DF,Norberto L

doi

10.1016/j.transproceed.2007.05.053

subject

Has Abstract

pub_date

2007-07-01 00:00:00

pages

1942-4

issue

6

eissn

0041-1345

issn

1873-2623

pii

S0041-1345(07)00632-X

journal_volume

39

pub_type

杂志文章

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