Endoscopic stent placement above the sphincter of Oddi for biliary strictures after living donor liver transplantation.

Abstract:

BACKGROUND:Endoscopic balloon dilation and/or plastic stent placement has been a standard method for treating biliary strictures complicated post living donor liver transplantation (LDLT). The strictures may be refractory to endoscopic treatment and require long-term stent placement. However, consensus on the optimal period of the stent indwelling and usefulness of the inside stent does not exist. METHODS:We evaluated the long-term efficacy of stent treatment in patients with biliary stricture post LDLT. In addition, we compared the stent patency between inside stent and conventional outside stent. RESULTS:A total of 98 ERC sessions (median 6: range 1-14) performed on 16 patients receiving endoscopic treatment for biliary strictures post LDLT with duct-to-duct biliary reconstruction were analyzed. Biliary strictures successfully treated in 14 patients (88%) included 7 patients (44%) showing improvement of biliary strictures with repeated endoscopic stent placement. Stent replacement was carried out every 6 to 12 months for the remainder 7 patients (44%). Biliary stents were placed in 87 sessions (77 inside sessions and 10 outside sessions). Stent migration occurred 13 times (16%) and none of the inside stent sessions and the outside stent sessions, respectively. Median patency of inside stent and outside stent were 222 days (range; 8-1736) and 99 days (range; 7-356), respectively. The stent occlusion was significantly less in inside stent than in outside stent (p < 0.001). Stone formation was observed in 14 (18%) of the inside stent and 3 (30%) of the outside stent. Biliary stones were small and successfully removed endoscopically. CONCLUSIONS:The endoscopic treatment using inside stent was useful in the management of biliary strictures after LDLT.

journal_name

BMC Gastroenterol

journal_title

BMC gastroenterology

authors

Koizumi M,Kumagi T,Kuroda T,Imamura Y,Kanemitsu K,Ogawa K,Takada Y,Hiasa Y

doi

10.1186/s12876-020-01226-x

subject

Has Abstract

pub_date

2020-04-06 00:00:00

pages

92

issue

1

issn

1471-230X

pii

10.1186/s12876-020-01226-x

journal_volume

20

pub_type

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