ENDOSCOPIC TREATMENT OF BILIARY COMPLICATIONS AFTER LIVER TRANSPLANTATION TAKEN FROM A LIVING DONOR
Keywords:endoscopy, liver transplantation, biliary complication, living donor
The results of our study show the efficacy and safety of the stepwise endoscopic treatment of strictures and lack of biliobiliary anastomoses in most patients. Diagnostic and therapeutic transpapillary interventions after orthotopic liver transplantation include endoscopic retrograde cholangiopancreatography, endoscopic papillosphincterotomy and, in case of necessity, balloon dilatation of the biliobiliary anastomosis along with prosthetics with plastic stents, replacing them with fully covered self-expanding metallic stents 3-6 months later. After analyzing the results of the obtained data, we may draw the following important conclusion that endoscopic retrograde cholangiopancreatography remains a highly effective method of diagnosis and treatment of all biliary complications arising from orthotopic liver transplantation from a living donor.
Alazmi W.M., Fogel E.I., Watkins J.L. et al. - Recurrence rate of anastomotic biliary strictures in patients who have had previous successful endoscopic therapy for anastomotic narrowing after orthotopic liver transplantation. Endoscopy 2006;38(6):571-4.
Buis C.I., Verdonk R.C., et al.- Nonanastomotic biliary strictures after liver transplantation, Part 1: Radiological features and risk factors for early vs. late presentation. Liver Transplantat 2007;13:708-18.
Belenkey A., Moor E. et al. Transhepatic baloon dilatation of early biliary strictures in pediatric liver transplantation: successful initial and mid-term outcome. Cardiovasc Intervent Radiol 2004;27:491-4.
Cameron A., Busutil R.W., - Ischemic cholangiopathy after liver transplantation. Hepatobiliary Pancreat Dis Int 2005;4:495-501.
Moser M.A.J., Wall W.J. - Management of biliary problems after liver transplantation. Liver Transplantat – 2007; 11(1):46-52.
Hintze R.E., Abou-Rebyeh H., Adler A. et al. - Endoscopic therapy of ischemic type biliary lesions (ITBL) in patients after orthotopic liver transplantation. Z Gastroenterol 1999;37:13-20.
Pascher A., Neuhaus P - Biliary complications after deceased-donor orthotopic liver transplantation. J Hepatobiliary Pancreat Surg 2006;13:487-96.
Pomposelli J.J., Jenkins R.I. - Early and late complication of liver transplantation. In: L.H. Blumgart, ed. Surgery of the liver, biliary tract and pancreas. 4th ed. Philadelphia: Saunders Elseiver, 2007; vol.2:1801-2
Londono M., Balderramo D., Cardenas A. - Patkowski W. Management of biliary complications after orthotopic liver transplantation: the role of endoscopy. World J Gastroenterol 2008;14(4): 493-7.
Sharma S., Gurakar A., Jabbour N., Zuhdi N. Biliary strictures following liver transplantation: past, present and preventive strategies. Transplantation 2008;14:759-69.
Jia-Zhi Liao, Qui Zhao, Hua Qin et al. Endoscopic diagnosis and treatment of biliary leak in patients following liver transplantation: a prospective clinical study. J Hepatobiliary Pancreat Dis Int 2007;6:29-3.
Ting-Bo Ling - Biliary tract complication after liver transplantation. Hepatobiliary Pancreat Dis Int 2005;4(1):10-1.
Zoepf T., Maldonada-Lopez E.J., Hilgard P. et al. Diagnosis of biliary strictures after liver transplantation: Which is the best tool? World J Gastroenterol 2005;11(19):2945-8.