Outcomes of management for biliary stricture after living donor liver transplantation with hepaticojejunostomy using short-type double-balloon enteroscopy.

Abstract

BACKGROUND AND AIMS:

To evaluate the outcomes of management for biliary stricture (BS) after living donor liver transplantation (LDLT) using short-type double-balloon enteroscopy.

METHODS:

This study retrospectively evaluated 20 patients who underwent endoscopic retrograde cholangiography using short-type double-balloon enteroscopy (sDB-ERC) upon suspicion of BS after LDLT with hepaticojejunal (HJ) reconstruction at Okayama University Hospital.

RESULTS:

Scope insertion to the HJ site and sDB-ERC succeeded in 85 % (17/20) and 82.4 % (14/17) of patients, respectively. Of 14 patients who required treatment for BS, 11 were successfully treated using sDB-ERC, and 3 were successfully treated using sDB-ERC and rendezvous procedures. Adverse events occurred in 2.9 % of all sessions (2/68). After resolution of BS, 7 patients (50 %) experienced a recurrence. Of these, 6 (85.7 %) were treated with only balloon dilation, and 1 (14.3 %) was treated with both balloon dilation and stent deployment (P = 0.029).

CONCLUSIONS:

sDB-ERC is a useful procedure for diagnosis and treatment for BS after LDLT with HJ reconstruction. Balloon dilation combined with stent deployment might be recommended for definite resolution of BS.

• Authors: Takeshi Tomoda, Koichiro Tsutsumi, Hironari Kato, Sho Mizukawa, Syuntaro Yabe, Yutaka Akimoto, Hiroyuki Seki, Daisuke Uchida, Kazuyuki Matsumoto, Naoki Yamamoto, Shigeru Horiguchi, Hiroyuki Okada
• Journal: Surgical endoscopy (Surg Endosc) Vol. 30 Issue 12 Pg. 5338-5344 (12 2016) ISSN: 1432-2218 [Electronic] Germany
• PMID: 27059976 (Publication Type: Evaluation Study, Journal Article)

Topics

• Adult
• Aged
• Anastomosis, Surgical
• Child
• Child, Preschool
• Cholestasis, Extrahepatic (etiology, therapy)
• Double-Balloon Enteroscopy (instrumentation, methods)
• Female
• Follow-Up Studies
• Hepatic Duct, Common (surgery)
• Humans
• Jejunum (surgery)
• Liver Transplantation (methods)
• Living Donors
• Male
• Middle Aged
• Postoperative Complications (therapy)
• Recurrence
• Retrospective Studies
• Stents
• Treatment Outcome