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Journal of Hepato-Biliary-Pancreatic Sciences

Published in:

01-03-2011 | Original article

Complications of the treatment of endoscopic biliary strictures developing after liver transplantation

Authors: Noritoshi Kobayashi, Kensuke Kubota, Takeshi Shimamura, Seitaro Watanabe, Shingo Kato, Kaori Suzuki, Takashi Uchiyama, Shin Maeda, Kazuhisa Takeda, Atsushi Nakajima, Itaru Endo

Published in: Journal of Hepato-Biliary-Pancreatic Sciences | Issue 2/2011

Abstract

Background

Bile duct strictures remain a major source of morbidity after orthotopic liver transplantation (OLT). Endoscopic management by the conventional methods of biliary dilatation and/or stent placement has been successful, but sometimes severe complications occur, necessitating prolonged therapy. The aim of this study is to clarify the complications of the endoscopic approach for endoscopic dilatation and/or stent placement.

Method

Of 46 patients who underwent living-donor liver transplantation, 10 were diagnosed as having anatomic biliary strictures by endoscopic retrograde cholangiopancreatography (ERCP). Two patients developing biliary strictures after deceased-donor liver transplantation were also enrolled in the study. For the purpose of comparison, 302 patients with a total of 550 consecutive ERCP cases (including 115 patients with 250 malignant bile duct strictures) were recruited in this study. Success rate, number of endoscopy sessions, the median procedure time for ERCP, and incidence of complications including post-ERCP pancreatitis were compared in the OLT cases and other cases.

Results

The following results were obtained in the OLT cases, malignant stricture cases, and all cases, respectively: mean number of endoscopy sessions was 3.62, 2.17, and 1.94 (P = 0.0216, P < 0.0001); post-ERCP pancreatitis occurred in 5 (12.5%), 10 (4.0%), and 19 cases (3.5%) (P = 0.0327, P = 0.0093); and severe pancreatitis occurred in 2 cases of OLT. In a univariate analysis for post-ERCP pancreatitis, OLT was extracted as the only significant risk factor.

Conclusions

Endoscopic maneuvering for biliary dilatation and/or stent placement following OLT was associated with a higher risk of post-ERCP pancreatitis than the use of the same technique for the treatment of malignant biliary stricture. Endoscopic treatment after OLT was a significant risk factor for post-ERCP pancreatitis.

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Title: Complications of the treatment of endoscopic biliary strictures developing after liver transplantation
Authors: Noritoshi Kobayashi
Kensuke Kubota
Takeshi Shimamura
Seitaro Watanabe
Shingo Kato
Kaori Suzuki
Takashi Uchiyama
Shin Maeda
Kazuhisa Takeda
Atsushi Nakajima
Itaru Endo
Publication date: 01-03-2011
Publisher: Springer Japan
Published in: Journal of Hepato-Biliary-Pancreatic Sciences / Issue 2/2011
Print ISSN: 1868-6974
Electronic ISSN: 1868-6982
DOI: https://doi.org/10.1007/s00534-010-0330-0

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Complications of the treatment of endoscopic biliary strictures developing after liver transplantation

Abstract

Background

Method

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Method

Results

Conclusions

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