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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.

Author information

1
Division of Gastroenterology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
2
Division of Gastroenterology, Department of Internal Medicine, Good GangAn Hospital, Busan, Korea.
3
Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

Abstract

Background/Aims:

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.

Methods:

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.

Results:

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).

Conclusions:

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.

KEYWORDS:

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

PMID:
30970446
DOI:
10.5009/gnl18387
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