| Biliary strictures after liver transplantation. Predictive factors for response to endoscopic management and long-term outcome. | |
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MedLine Citation:
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PMID: 18552573 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Jose Barriga; Roy Thompson; Hosein Shokouh-Amiri; Rena Davila; Mohammad K Ismail; Bradford Waters; Claudio R Tombazzi |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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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:
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Created Date: 2008-06-16 Completed Date: 2008-07-25 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0370506 Medline TA: Am J Med Sci Country: United States |
Other Details:
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Languages: eng Pagination: 439-43 Citation Subset: AIM; IM |
Affiliation:
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Department of Medicine, University of Tennessee, Tennessee, USA. |
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| MeSH Terms | |
Descriptor/Qualifier:
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Anastomosis, Surgical
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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 |
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