Preliminary safety and efficacy of laser stricturotomy for treatment of refractory biliary anastomotic strictures following liver transplantation.

Abstract

Biliary anastomotic stricture (BAS) is a frequent complication of liver transplantation and is associated with reduced graft survival and patient morbidity. Existing treatments for BAS involve dilation of the stricture though placement of 1 or more catheters for 6 to 24 months yielding limited effectiveness in transplant patients. In this case series, we present preliminary safety and efficacy of a novel percutaneous laser stricturotomy treatment in a cohort of 5 posttransplant patients with BAS refractory to long-term large bore catheterization. In all patients, holmium or thulium laser was used to excise the stricture and promote biliary re-epithelization. There were no periprocedural complications. Technical success was 100% and at mean follow-up time of 22 months, there have been no recurrences. In conclusion, percutaneous laser stricturotomy demonstrates preliminary safety and efficacy in treatment of refractory BAS following liver transplantation.

• Authors: Premal Trivedi, Jessica L Saben, Lisa Liu, John S Malamon, Elizabeth Pomfret, Thomas Pshak
• Journal: American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons (Am J Transplant) Vol. 23 Issue 4 Pg. 573-576 (04 2023) ISSN: 1600-6143 [Electronic] United States
• PMID: 36695697 (Publication Type: Case Reports)
• Copyright: Copyright © 2022 American Society of Transplantation & American Society of Transplant Surgeons. Published by Elsevier Inc. All rights reserved.

Topics

• Humans
• Liver Transplantation (adverse effects)
• Cholestasis (etiology, surgery)
• Constriction, Pathologic (etiology, surgery)
• Treatment Outcome
• Catheterization (adverse effects)
• Retrospective Studies