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Outcome of ischemic and non-ischemic biliary stenosis following liver transplantation treated with percutaneous interventions: The bologna experience.
MedLine Citation:
PMID:  22006838     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
In liver transplantation (LT), biliary strictures (BS) are one of the most common complications. The aim of this study was to evaluate the efficacy of percutaneous treatment in the management of post-LT BS. From 1999 to 2007, 48 patients underwent percutaneous treatment of post-transplant BS. We divided the population into two groups according to the ischemic (n=14) and non-ischemic (n=34) cause and in further sub-groups in relation to the anastomotic (n=34) or non-anastomotic (n=14) site. All patients were treated with bilioplasty; in 9 patients refractory to bilioplasty, metallic stents were implanted. A technical success rate of 90% was achieved without differences between ischemic vs non-ischemic groups and anastomotic vs non-anastomotic sub-groups (P=0.10). The major complication rate was 4%. The overall 1- and 3-years primary patency rates were 94% and 45%, respectively, with better results (P=0.03) in non-ischemic vs ischemic stenosis. The overall secondary patency rates were 94% and 83% at 1- and 3-years, respectively, without statistical differences between ischemic vs non-ischemic or anastomotic vs non-anastomotic stenosis. In the stent subgroup, overall 1- and 2-years primary and secondary patency rates were 100%, 71%, 100% and 100%, respectively. The percutaneous approach is highly effective in the treatment of post-LT BS, with best results obtained in simple, non-ischemic BS, with a technical success rate of 94%, and 3-year primary and secondary patency rates of 81% and 83%, respectively. In ischemic BSs, closer follow-up and retreatment is more frequently needed to achieve secondary patency rates comparable to, or even better than the non-ischemic stenoses. Liver Transpl, 2011. © 2011 AASLD.
Authors:
Emanuela Giampalma; Matteo Renzulli; Cristina Mosconi; Giorgio Ercolani; Antonio Daniele Pinna; Rita Golfieri
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-10-17
Journal Detail:
Title:  Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society     Volume:  -     ISSN:  1527-6473     ISO Abbreviation:  -     Publication Date:  2011 Oct 
Date Detail:
Created Date:  2011-10-18     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100909185     Medline TA:  Liver Transpl     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 American Association for the Study of Liver Diseases.
Affiliation:
Radiology Unit, Department of Digestive Diseases and Internal Medicine; Sant'Orsola-Malpighi Hospital, University of Bologna, Italy. emanuela.giampalma@aosp.bo.it.
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