BACKGROUND: Post-liver-transplant anastomotic biliary strictures generally have been managed through ERCP with gradual balloon dilation and placement of multiple stents over an extended period of time. OBJECTIVE: Our purpose was to evaluate the long-term outcome of rapid sequence dilation and to shorten the duration of stenting as a therapy for anastomotic biliary strictures. DESIGN: Prospective case series. SETTING: Academic tertiary referral center. INTERVENTIONS: ERCP with rapid-sequence balloon dilation of post-liver-transplant anastomotic biliary strictures followed by stenting with multiple stents over a short time period. MAIN OUTCOME MEASUREMENT: Long-term anastomotic stricture resolution. RESULTS: Thirty-eight patients were prospectively enrolled into a standardized ERCP treatment protocol. The mean number of ERCPs per patient was 3.4 (range 2-6), the mean number of maximum stents inserted was 2.5 (range 1-6), and the mean total stenting period was 107 days (range 20-198 days); the mean follow-up time from completion of the endoscopic therapy was 360 days (range 140-1347 days). Long-term stricture resolution was achieved in 33 of the 38 (87%) patients. LIMITATIONS: Lack of control group, relatively small patient population. CONCLUSIONS: Accelerated dilation and shorter total length of stenting leads to long-term success in the majority of patients with post-liver-transplant anastomotic biliary strictures.
BACKGROUND: Post-liver-transplant anastomotic biliary strictures generally have been managed through ERCP with gradual balloon dilation and placement of multiple stents over an extended period of time. OBJECTIVE: Our purpose was to evaluate the long-term outcome of rapid sequence dilation and to shorten the duration of stenting as a therapy for anastomotic biliary strictures. DESIGN: Prospective case series. SETTING: Academic tertiary referral center. INTERVENTIONS: ERCP with rapid-sequence balloon dilation of post-liver-transplant anastomotic biliary strictures followed by stenting with multiple stents over a short time period. MAIN OUTCOME MEASUREMENT: Long-term anastomotic stricture resolution. RESULTS: Thirty-eight patients were prospectively enrolled into a standardized ERCP treatment protocol. The mean number of ERCPs per patient was 3.4 (range 2-6), the mean number of maximum stents inserted was 2.5 (range 1-6), and the mean total stenting period was 107 days (range 20-198 days); the mean follow-up time from completion of the endoscopic therapy was 360 days (range 140-1347 days). Long-term stricture resolution was achieved in 33 of the 38 (87%) patients. LIMITATIONS: Lack of control group, relatively small patient population. CONCLUSIONS: Accelerated dilation and shorter total length of stenting leads to long-term success in the majority of patients with post-liver-transplant anastomotic biliary strictures.
Authors: Sophoclis P Alexopoulos; Joy A Henningsen; R Brooke Jeffrey; C Andrew Bonham; Aijaz Ahmed; Stevan A Gonzalez Journal: Dig Dis Sci Date: 2008-11-25 Impact factor: 3.199
Authors: H Goessmann; S A Lang; S Fichtner-Feigl; M N Scherer; H J Schlitt; C Stroszczynski; A G Schreyer; A A Schnitzbauer Journal: Chirurg Date: 2012-12 Impact factor: 0.955
Authors: Patrick Aepli; Andrew St John; Saurabh Gupta; Luke F Hourigan; Rhys Vaughan; Marios Efthymiou; Arthur Kaffes Journal: Surg Endosc Date: 2016-08-29 Impact factor: 4.584
Authors: Peter V Draganov; Lukasz Kowalczyk; Ali Fazel; Koorosh Moezardalan; Jen-Jung Pan; Chris E Forsmark Journal: Dig Dis Sci Date: 2010-02 Impact factor: 3.199