Johannes M Ludwig1, Grant R Webber2, Stuart J Knechtle3, James R Spivey4, Minzhi Xing1, Hyun S Kim5. 1. Division of Interventional Radiology, Department of Radiology and Biomedical Imaging Yale University School of Medicine, 330 Cedar St., TE 2-224, New Haven, CT 06510. 2. Division of Interventional Radiology and Image Guided Medicine, Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia. 3. Duke Transplant Center, Department of Surgery, Duke University School of Medicine, Durham, North Carolina. 4. Division of Digestive Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia. 5. Division of Interventional Radiology, Department of Radiology and Biomedical Imaging Yale University School of Medicine, 330 Cedar St., TE 2-224, New Haven, CT 06510. Electronic address: kevin.kim@yale.edu.
Abstract
PURPOSE: To prospectively evaluate stricture resolution and patency rates of benign biliary strictures treated with percutaneous large-bore catheter "stenting" in patients with and without previous orthotopic liver transplantation (OLT) and to compare treatment outcomes between these two groups. MATERIALS AND METHODS: Forty-six consecutive patients (25 with OLT) underwent percutaneous catheter placement in extrahepatic and single-site biliary stricture for 6-8 months, with progressive catheter upsizing to 18-20 F. Primary patency rate was defined as the proportion of patients without recurrent bile duct stricture during the follow-up period after successful stricture resolution. Secondary patency rate was defined as the proportion of patients with a patent bile duct at the end of follow-up after stricture resolution, including patients with stricture recurrence and successful repeat percutaneous biliary catheter treatment. RESULTS: Eleven patients terminated the protocol early, 6 as a result of treatment-related reasons in the orthotopic liver transplantation (OLT) group. Sixty-four percent of the OLT group and 86.4% of control patients successfully completed the protocol, with resolved biliary strictures (P = .1) after a median treatment time of 7 months for both groups (P = .96). During mean follow-up times of 20.3 months ± 11.8 (standard deviation) and 13.1 months ± 11.73 for OLT and non-OLT patients (P = .08), respectively, the primary/secondary patency rates were comparable between groups, at 81.25%/87.5% for OLT patients and 89.5%/100% for non-OLT patients (P = .64/P = .2). The mean time to recurrent stricture was 11.2 months ± 11.88. CONCLUSIONS: Percutaneous large-bore catheter treatment of benign, single-site biliary strictures showed a promising rate of stricture resolution, with comparable high primary and secondary patency rates in patients with and without previous OLT.
PURPOSE: To prospectively evaluate stricture resolution and patency rates of benign biliary strictures treated with percutaneous large-bore catheter "stenting" in patients with and without previous orthotopic liver transplantation (OLT) and to compare treatment outcomes between these two groups. MATERIALS AND METHODS: Forty-six consecutive patients (25 with OLT) underwent percutaneous catheter placement in extrahepatic and single-site biliary stricture for 6-8 months, with progressive catheter upsizing to 18-20 F. Primary patency rate was defined as the proportion of patients without recurrent bile duct stricture during the follow-up period after successful stricture resolution. Secondary patency rate was defined as the proportion of patients with a patent bile duct at the end of follow-up after stricture resolution, including patients with stricture recurrence and successful repeat percutaneous biliary catheter treatment. RESULTS: Eleven patients terminated the protocol early, 6 as a result of treatment-related reasons in the orthotopic liver transplantation (OLT) group. Sixty-four percent of the OLT group and 86.4% of control patients successfully completed the protocol, with resolved biliary strictures (P = .1) after a median treatment time of 7 months for both groups (P = .96). During mean follow-up times of 20.3 months ± 11.8 (standard deviation) and 13.1 months ± 11.73 for OLT and non-OLT patients (P = .08), respectively, the primary/secondary patency rates were comparable between groups, at 81.25%/87.5% for OLT patients and 89.5%/100% for non-OLT patients (P = .64/P = .2). The mean time to recurrent stricture was 11.2 months ± 11.88. CONCLUSIONS: Percutaneous large-bore catheter treatment of benign, single-site biliary strictures showed a promising rate of stricture resolution, with comparable high primary and secondary patency rates in patients with and without previous OLT.
Authors: Elisabeth Dhondt; Peter Vanlangenhove; Hans Van Vlierberghe; Roberto Troisi; Ruth De Bruyne; Lynn Huyck; Luc Defreyne Journal: Eur Radiol Date: 2018-07-06 Impact factor: 5.315
Authors: Miguel A De Gregorio; Eva Criado; Jose A Guirola; Enrique Alvarez-Arranz; Mercedes Pérez-Lafuente; Marta Barrufet; Maria D Ferrer-Puchol; Sandra Lopez-Minguez; Jose Urbano; Carlos Lanciego; Alexander Aguinaga; Antonio Capel; Maria D Ponce-Dorrego; Abel Gregorio Journal: Eur Radiol Date: 2020-03-27 Impact factor: 5.315