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anastomotic stricture liver transplant

Kenneth S H Chok, Chung Mau Lo
BACKGROUND: The chance of biliary complication after living donor liver transplantation (LDLT) is considerable. The objective of this study was to investigate the impact of biliary reconstruction method on post-LDLT biliary complications. Data sources are from PubMed and Web of Science. METHODS: A systematic search was conducted using the search term '[biliary complications] OR [biliary complication] OR [biliary stricture] OR [bile leak] AND [living donor liver transplantation]'...
November 11, 2016: ANZ Journal of Surgery
R De Carlis, S Di Sandro, A Lauterio, F Ferla, A Dell'Acqua, M Zanierato, L De Carlis
The role of donation after cardiac death (DCD) in expanding the donor pool is mainly limited by the incidence of primary non-function (PNF) and ischemia-related complications. Even greater concern exists towards uncontrolled DCD, which represents the largest potential pool of DCD donors. We recently started the first Italian series of DCD liver transplantation, using normothermic regional perfusion (NRP) in 6 uncontrolled donors and in 1 controlled case to deal with the legally required no-touch period of 20 minutes...
October 26, 2016: Liver Transplantation
Dong Wook Lee, Hyeong Ho Jo, Juveria Abdullah, Michel Kahaleh
Endoscopic treatment of biliary strictures involving plastic stent placement has been used widely. The use of self-expandable metal stents (SEMSs) has been described for anastomotic strictures following liver transplantation (LT). This review aimed to assess and compare the efficacy of plastic stents with SEMS in LT patients. Information was retrieved regarding technical success, stricture resolution, the number of endoscopic retrograde cholangiography procedures, follow-up, immediate, and late complications...
September 2016: Clinical Endoscopy
M Jiménez-Pérez, J M Melgar Simón, A Durán Campos, R González Grande, J M Rodrigo López, R Manteca González
OBJECTIVE: The aim of this work was to evaluate the safety and efficacy of a fully covered self-expandable metal stent (FCSEMS) in the treatment of post-liver transplantation biliary strictures. METHODS: From October 2009 to October 2014, 44 patients with post-liver transplantation biliary stenosis were treated with the use of endoscopic retrograde cholangiography and placement of FCSEMS after informed consent. The FCSEMS was scheduled to remain in situ for 3-6 months...
September 2016: Transplantation Proceedings
Min-Ho Shin, Deok-Bog Moon, Sung-Gyu Lee, Shin Hwang, Ki-Hun Kim, Chul-Soo Ahn, Tae-Yong Ha, Gi-Won Song, Dong-Hwan Jung, Gil-Chun Park, Young-In Yun, Wan-Jun Kim, Woo-Hyoung Kang, Seok-Hwan Kim, Gi-Young Ko
BACKGROUND: Although perioperative portal vein (PV) stent implantation is an effective treatment for steno-occlusive disease in adult living donor liver transplantation (LDLT) recipients, we experienced high incidence of biliary anastomotic strictures (BAS) after PV stenting. In this study, we sought to clarify the relation between BAS and PV stenting and to suggest the possible mechanism of BAS and measures to reduce its incidence. METHODS: We retrospectively analyzed 44 LDLT recipients who underwent PV stent implantation across the line of PV anastomosis regardless of the location of steno-occlusion (stent group) and their matched controls (non-stented LDLT recipients, n=131)...
October 2016: Hepatobiliary & Pancreatic Diseases International: HBPD INT
Patrick Aepli, Andrew St John, Saurabh Gupta, Luke F Hourigan, Rhys Vaughan, Marios Efthymiou, Arthur Kaffes
BACKGROUND: Anastomotic biliary strictures (AS) after orthotopic liver transplantation (OLT) belong to the most common biliary complications and cause the biggest morbidity burden after OLT. Metal stents for benign biliary strictures are gaining acceptance with many published series. Traditional metal stent designs seem to have poor durability in AS after OLT. Novel intra-ductal stents are showing promise in these strictures. As a result, we designed a special stent with an antimigration waist and a short stent length with a long removal string that rests in the duodenum for easy removal...
August 29, 2016: Surgical Endoscopy
Erkan Parlak, Aydın Seref Koksal, Fahrettin Kucukay, Ahmet Tarık Eminler, Bilal Toka, Mustafa Ihsan Uslan
BACKGROUND AND AIMS: Magnetic compression anastomosis is a rescue technique for recanalization of complete biliary strictures. Here, we present magnetic compression anastomosis with novel through-the-scope magnets in patients with complete duct-to-duct anastomosis obstruction after liver transplantation. METHODS: The magnets were 2 and 2.4 mm in diameter, with a hole at the center for inserting a guidewire. One of the magnets was advanced through the scope up to the distal site of the stricture by using a 7F pusher...
August 24, 2016: Gastrointestinal Endoscopy
In Joon Lee, Seong Hoon Kim, Seung Duk Lee, Jae Hwan Lee, Hyun Beom Kim
PURPOSE: To evaluate the feasibility and midterm results of endovascular treatment of hepatic artery occlusion within 24 hours after living-donor liver transplantation (LDLT). MATERIALS AND METHODS: From January 2012 to June 2014, 189 consecutive patients at a single institution underwent LDLT with right-lobe grafts. Among them, 10 were diagnosed with hepatic artery occlusion within 24 hours after LDLT. All 10 underwent endovascular treatment, including drug-eluting stent placement (n = 2), intraarterial thrombolysis (n = 5), or both (n = 3)...
August 22, 2016: Journal of Vascular and Interventional Radiology: JVIR
C J Verhoeven, T C Simon, J de Jonge, M Doukas, K Biermann, H J Metselaar, J N M IJzermans, W G Polak
: Microthrombi formation provoked by warm ischemia and vascular stasis is thought to increase the risk of non-anastomotic biliary strictures (NAS) in liver grafts obtained by donation after circulatory death (DCD). Therefore, potentially harmful intraoperative thrombolytic therapy has been suggested as a preventive strategy against NAS. Here, we investigated whether there is histological evidence of microthrombi formation during graft preservation or directly post-reperfusion in DCD livers and the development of NAS...
August 19, 2016: Liver Transplantation
Nicholas Gilbo, Ina Jochmans, Mauricio Sainz, Jacques Pirenne, Diethard Monbaliu, Nicolas Meurisse
No abstract text is available yet for this article.
August 5, 2016: Annals of Surgery
Julie Navez, Nicolas Golse, Brigitte Bancel, Agnès Rode, Christian Ducerf, Salim Mezoughi, Kayvan Mohkam, Jean-Yves Mabrut
BACKGROUND: Traumatic biliary neuromas (TBNs) represent a rare cause of biliary stricture (BS) after orthotopic liver transplantation (OLT). Diagnosis is challenging preoperatively and is most often made at pathology after resection. Herein we report a 20-year experience of TBN-related BS. PATIENTS AND METHODS: Medical records of 1030 adult patients undergoing OLT from 1991 to 2014 were reviewed. Patients with histologically proven TBN were identified among those presenting a BS...
July 13, 2016: Clinical Transplantation
Ulriikka Chaput, Ariane Vienne, Etienne Audureau, Paul Bauret, Philippe Bichard, Dimitri Coumaros, Bertrand Napoléon, Thierry Ponchon, Jean-Christophe Duchmann, René Laugier, Hervé Lamouliatte, Bruno Védrenne, Marianne Gaudric, Stanislas Chaussade, Françoise Robin, Sarah Leblanc, Frédéric Prat
BACKGROUND: Endoscopic treatment of benign biliary strictures (BBS) can be challenging. OBJECTIVE: To evaluate the efficacy of fully covered self-expandable metal stents (FCSEMS) in BBS. METHODS: Ninety-two consecutive patients with BBS (chronic pancreatitis (n = 42), anastomotic after liver transplantation (n = 36), and post biliary surgical procedure (n = 14)) were included. FCSEMS were placed across strictures for 6 months before endoscopic extraction...
June 2016: United European Gastroenterology Journal
Dai Hoon Han, Dong Jin Joo, Myoung Soo Kim, Gi Hong Choi, Jin Sub Choi, Young Nyun Park, Jinsil Seong, Kwang Hyub Han, Soon Il Kim
Locally advanced hepatocellular carcinoma (HCC) with portal vein thrombosis carries a 1-year survival rate <10%. Localized concurrent chemoradiotherapy (CCRT), followed by hepatic arterial infusion chemotherapy (HAIC), was recently introduced in this setting. Here, we report our early experience with living donor liver transplantation (LDLT) in such patients after successful down-staging of HCC through CCRT and HAIC. Between December 2011 and September 2012, eight patients with locally advanced HCC at initial diagnosis were given CCRT, followed by HAIC, and underwent LDLT at the Severance Hospital, Seoul, Korea...
September 2016: Yonsei Medical Journal
Sushrut Trakroo, Kamran Qureshi
Hepatic arterial flow is paramount in preserving biliary integrity. We present an interesting clinical scenario of a liver transplant recipient with biliary anastomotic stricture who developed biliary abscess and sepsis after Endoscopic Retrograde Cholangiopancreatography. The abscess did not respond to maximal medical management, percutaneous drainage, and adequate endoscopic biliary drainage. Clinically, patient continued to deteriorate and imaging identified hepatic artery stenosis which was treated with percutaneous intra-arterial stenting...
2016: Case Reports in Transplantation
(no author information available yet)
No abstract text is available yet for this article.
June 2016: Endoscopy
Paolo Cantù, Andrea Tenca, Ilaria Parzanese, Roberto Penagini
There is growing interest in using covered self-expandable metal stents for the treatment of benign biliary conditions, and the presence of anastomotic biliary strictures and leaks after liver transplantation provide a valuable opportunity for testing them. The performance of the stents is encouraging, and the technical success rate is high. They provide larger diameter dilation and are easily removed, and can potentially limit costs by reducing the number of procedures needed to treat anastomotic biliary strictures...
August 2016: Digestive and Liver Disease
Takeshi Tomoda, Hironari Kato, Sho Mizukawa, Syuntaro Yabe, Yutaka Akimoto, Hiroyuki Seki, Daisuke Uchida, Kazuyuki Matsumoto, Naoki Yamamoto, Shigeru Horiguchi, Koichiro Tsutsumi, Hiroyuki Okada
BACKGROUND: To evaluate the outcomes and investigate the factors associated with restricture after endoscopic treatment. METHODS: Between April 2001 and July 2014, 98 patients experienced biliary anastomotic stricture (BAS) after living donor liver transplantation (LDLT) with duct-to-duct reconstruction, and all were first referred to Okayama University Hospital for endoscopic stent deployment. When deployment was unsuccessful, a percutaneous transhepatic procedure was used...
July 2016: Transplantation
I Leale, E Moraglia, G Bottino, M Rachef, L Dova, A Cariati, A De Negri, P Diviacco, E Andorno
BACKGROUND: The aim of this study was to report 2 cases of liver transplantation (LT) for iatrogenic bile-vascular injury (BVI) sustained during cholecystectomy and to review the literature for LT after cholecystectomy. METHODS: Between March 2001 and July 2013, within our institution, 12 patients were treated after cholecystectomy, 3 of 12 received LT, 1 for acute de-compensation in a cirrhotic patient and 2 after iatrogenic lesions. RESULTS: The majority of iatrogenic injury occurred during video-laparocholecystectomy (63,6%; 7/11)...
March 2016: Transplantation Proceedings
Kilian Friedrich, Mark Smit, Maik Brune, Thomas Giese, Christian Rupp, Andreas Wannhoff, Petra Kloeters, Yvonne Leopold, Gerald Ulrich Denk, Karl Heinz Weiss, Wolfgang Stremmel, Peter Sauer, Simon Hohenester, Peter Schirmacher, Peter Schemmer, Daniel Nils Gotthardt
UNLABELLED: The pathogenesis of intrahepatic biliary stricture formation in patients with primary sclerosing cholangitis (PSC) or after liver transplantation (LTx) remains elusive. CD14 receptor signaling is a key mediator of the innate immune system; its common genetic variant is associated with alcoholic liver disease. PSC and LTx cohort patients and primary biliary cirrhosis (PBC) control patients were genotyped for the CD14 -260C>T (rs2569190) polymorphism, and genotypes were correlated with long-term clinical outcome...
September 2016: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
Abdullah Emre Yıldırım, Reskan Altun, Serkan Ocal, Murat Kormaz, Figen Ozcay, Haldun Selcuk
Experience with endoscopic retrograde cholangiopancreatography in the pediatric population is limited. The aim of this study was to evaluate the outcomes of ERCP in the pediatric population performed by adult gastroenterologists with standard duodenoscopes. This study is a structured retrospective review of endoscopic reports, computerized and paper medical records, and radiographic images of patients under the age of 18 who underwent ERCP for any indication at a tertiary referral centre. Data regarding demographic characteristics and medical history of patients, indications, technical success rate, final clinical diagnosis, and complications were analyzed...
2016: SpringerPlus
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