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Endoscopic treatment of bile duct complications after orthotopic liver transplantation.
- Source :
-
Transplantation proceedings [Transplant Proc] 2007 Jul-Aug; Vol. 39 (6), pp. 1942-4. - Publication Year :
- 2007
-
Abstract
- Aim: To assess the indications and results of endoscopic retrograde cholangio-pancreatography (ERCP) in patients who have undergone ortotopic liver transplantation (OLT).<br />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.<br />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.<br />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.
- Subjects :
- Anastomosis, Surgical
Bile Duct Diseases surgery
Bile Duct Diseases therapy
Cholangiopancreatography, Endoscopic Retrograde
Gallbladder surgery
Gallstones surgery
Humans
Plastic Surgery Procedures
Retrospective Studies
Bile Duct Diseases chemically induced
Liver Transplantation adverse effects
Subjects
Details
- Language :
- English
- ISSN :
- 0041-1345
- Volume :
- 39
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- Transplantation proceedings
- Publication Type :
- Academic Journal
- Accession number :
- 17692660
- Full Text :
- https://doi.org/10.1016/j.transproceed.2007.05.053