Endoscopic therapy of anastomotic bile duct strictures occurring after liver transplantation☆,☆☆
Section snippets
PATIENTS AND METHODS
Between January 1985 and December 1996, 721 liver transplants were performed in 641 patients who had undergone cholangiography for the primary purpose of treatment for anastomotic biliary strictures. Anastomotic strictures were defined as clinically significant when they were the dominant lesion identified at an ERCP performed for evaluation of jaundice, cholestasis or cholangitis. Patients with only modest strictures that did not appear to cause impairment of bile flow and those with
RESULTS
Overall, 15 patients underwent 23 ERCPs for post liver transplant anastomotic strictures. An end-to-end, donor-duct-to-recipient-duct biliary anastomosis (choledochocholedochostomy) had been performed in all patients. Among the 15 patients studied, 10 (66.7%) underwent a single procedure whereas 3 patients had 2, 1 had 3 and 1 had 4 ERCPs. Eleven patients (73%) were men and four (27%) were women. The average age was 50.6 years (range 15 to 66 years). Indications for transplantation included
DISCUSSION
Biliary tract complications are a significant source of morbidity after liver transplantation. Anastomotic strictures are among the most common of these complications. In a large series reported by Stratta et al.5 anastomotic strictures were noted in 8.3% of 105 patients. Similarly, among 1792 patients who underwent liver transplantation, Grief et al.1 noted 81 (4.5%) with anastomotic strictures. Despite their frequency, the ideal therapy for anastomotic strictures has yet to be defined. The
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Cited by (0)
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Reprint requests: Bret T. Petersen, MD, W19, Gastroenterology, Mayo Clinic, 201st St. S. W., Rochester, MN 55905.
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0016-5107/2000/$12.00 + 0 37/1/102997