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Gastrointest Endosc. 2008 May;67(6):879-85. doi: 10.1016/j.gie.2007.08.046. Epub 2008 Feb 21.

Rapid-sequence endoscopic management of posttransplant anastomotic biliary strictures.

Author information

1
Division of Gastroenterology, Hepatology and Nutrition, University of Florida, Gainesville, Florida 32610-0214, USA.

Abstract

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.

PMID:
18178206
DOI:
10.1016/j.gie.2007.08.046
[Indexed for MEDLINE]

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