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Gut Liver. 2019 Feb 27. doi: 10.5009/gnl18387. [Epub ahead of print]

Long-Term Outcome of Endoscopic Retrograde Biliary Drainage (ERBD) of Biliary Stricture Following Living Donor Liver Transplantation.

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Division of Gastroenterology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Division of Gastroenterology, Department of Internal Medicine, Good GangAn Hospital, Busan, Korea.
Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.



Biliary strictures remain one of the most challenging aspects after living donor liver transplantation (LDLT). The aim of this study is to assess long-term outcome of endoscopic treatment of biliary stricture occurring after LDLT and to identify risk factors of recurrent biliary stricture following endoscopic retrograde biliary drainage (ERBD) in LDLT.


A total of 1,441 patients underwent LDLT from May 1995 to May 2014. We compared the risk factors between patients with and without recurrent biliary strictures.


Biliary strictures developed in 24.0% of patients. Technical success rate of ERBD of biliary stricture after LDLT was 66.2% (145/219). Among 145 patients managed by endoscopic drainage, stricture resolution occurred in 69 (69/145) (median duration of stent indwelling, 13.6 months; range, 0.5 to 67.3 months), and stricture recurrence was seen in 20/94 (21.3%). Recurrence-free duration after final endoscopic success was a median 13.1 months (range, 0.5 to 67.3 months). Risk factors for stricture recurrence were donor age with lower recurrence rate (hazard ratio [HR], 1.10; 95% confidence intervals [Cis], 1.03 to 1.17; p=0.004) and non-B, non-C liver cirrhosis was associated with higher recurrence rate of biliary stricture (HR, 5.10; 95% Cis, 1.10 to 25.00; p=0.043).


Long-term outcome (stricture resolution) of the ERBD of biliary stricture occurring after LDLT was 73.4%. Clinicians should be pay careful attention to ERBD removal and follow-up in cases with factors associated with recurrent biliary stricture.


Biliary strictures; Endoscopic Retrograde Biliary Drainage (ERBD); Endoscopic treatment; Living Donor Liver Transplantation (LDLT)

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