Document Detail


Biliary strictures after liver transplantation. Predictive factors for response to endoscopic management and long-term outcome.
MedLine Citation:
PMID:  18552573     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Biliary strictures after liver transplantation are frequent. The long-term prognosis and predictive factors of response to endoscopic treatment are not well known. METHODS: The aim of this study was to demonstrate the role of endoscopic treatment, predictive factors of response, and outcome in patients with biliary stricture after liver transplantation. We performed a retrospective review of medical records of all consecutive post-liver transplantation patients who underwent endoscopic retrograde cholangiography in our center during the period from October 2001 to October 2006. RESULTS: Twenty-five of 43 patients referred for endoscopic retrograde cholangiography had biliary stricture. Eighteen had stricture at the area of the anastomosis alone, 2 patients had a stricture at the area of the anastomosis and also another area, and 5 had nonanastomotic biliary strictures. Twenty-one patients had a single stricture and 4 had more than 1 stricture. Initially 19 of 24 patients (79%) responded to endoscopic management with normalization of liver enzymes. Four patients (16%) did not respond clinically despite a successful endoscopic approach. All patients who did not respond to endoscopic dilation had more than 1 area of stricture. There was a significantly better response to endoscopic treatment in patients with an anastomotic stricture versus patients with nonanastomotic strictures 17/19 versus 2/5 (P = 0.042). CONCLUSIONS: In our experience, endoscopic treatment of anastomotic biliary strictures is highly effective with a good long-term outcome. The presence of nonanastomotic and multiple strictures should be considered a factor associated with poor response to endoscopic management.
Authors:
Jose Barriga; Roy Thompson; Hosein Shokouh-Amiri; Rena Davila; Mohammad K Ismail; Bradford Waters; Claudio R Tombazzi
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The American journal of the medical sciences     Volume:  335     ISSN:  0002-9629     ISO Abbreviation:  Am. J. Med. Sci.     Publication Date:  2008 Jun 
Date Detail:
Created Date:  2008-06-16     Completed Date:  2008-07-25     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370506     Medline TA:  Am J Med Sci     Country:  United States    
Other Details:
Languages:  eng     Pagination:  439-43     Citation Subset:  AIM; IM    
Affiliation:
Department of Medicine, University of Tennessee, Tennessee, USA.
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MeSH Terms
Descriptor/Qualifier:
Anastomosis, Surgical / adverse effects,  methods
Cholangiopancreatography, Endoscopic Retrograde / methods*
Cholestasis / diagnosis,  etiology*,  surgery
Humans
Liver Function Tests
Liver Transplantation / adverse effects*,  methods
Prognosis
Retrospective Studies
Time Factors
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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