Results of endoscopic management of anastomotic biliary strictures after orthotopic liver transplantation
Küçük Resim Yok
Tarih
2006
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Anastomoz bilyer darlıkları karaciğer nakli sonrası sıklıkla ortaya çıkabilen komplikasyonlardır. Karaciğer nakli sonrası ortaya çıkan anastomoz bilyer darlıklarının tedavisinde ERCP'nin başarısını değerlendirdik. Yöntem: İkiyüzonaltı karaciğer nakli hastasının 20'sinde 32 ERCP uygulandı. Bulgular: Hastaların beşinde darlığın kılavuz ile gecikmemesi nedeniyle ERCP başarısız olmuştur. Hastaların dördü sadece balon dilatasyonu ile tedavi edilirken bunlardan ikisi 24 ve 8 aydır nükssüz olarak takip edilmektedir. Sekiz hastaya primer tedavi olarak balon dilatasyonu ile beraber plastik stent uygulanması yapılmıştır. Bunların altısında, takibin geri kalanında (22±13 ay) anastomoz açık kalmıştır. Beşinde ilk stentle-me sonrası darlık nüks etmiş ve tekrar stentleme gerekirken, dördünde üçüncü stentleme ve üçünde dördüncü stentleme ihtiyacı olmuştur. Sonuç: Endoskopik balon dilatasyonu ve stentleme karaciğer nakli sonrası ortaya çıkan anastomoz bilyer darlıklarının tedavisinde etkili ve güvenli bir yoldur.
Background/aims: Anastomotic biliary strictures are common biliary complications after orthotopic liver transplantation. We assessed the success of endoscopic retrograde cholangio-pancreaticography (ERCP) in the treatment and outcome of post-liver transplantation anastomotic biliary strictures in a university hospital, retrospectively. Methods:Thirty-three ERCPs were performed in 20 of 162 adult liver transplant recipients with duct to duct anastomosis. Results:In five patients, ERCP failed because the stricture could not be passed with guidewire. Four patients were treated with balloon dilatation only; two of them are recurrence-free with a follow-up of 24 and 8 months. Eleven patients had balloon dilatation and plastic stent placement as their primary treatment modality. In six of them, the anastomosis remained patent for the rest of the follow-up (22 ± 13 months). Five patients had stricture recurrence after first stenting which necessitated re-stenting; four of them required a third, and three had a fourth stenting. Conclusions: Endoscopic balloon dilatation and stenting are safe and effective means of treatment of anastomotic biliary strictures following liver transplantation.
Background/aims: Anastomotic biliary strictures are common biliary complications after orthotopic liver transplantation. We assessed the success of endoscopic retrograde cholangio-pancreaticography (ERCP) in the treatment and outcome of post-liver transplantation anastomotic biliary strictures in a university hospital, retrospectively. Methods:Thirty-three ERCPs were performed in 20 of 162 adult liver transplant recipients with duct to duct anastomosis. Results:In five patients, ERCP failed because the stricture could not be passed with guidewire. Four patients were treated with balloon dilatation only; two of them are recurrence-free with a follow-up of 24 and 8 months. Eleven patients had balloon dilatation and plastic stent placement as their primary treatment modality. In six of them, the anastomosis remained patent for the rest of the follow-up (22 ± 13 months). Five patients had stricture recurrence after first stenting which necessitated re-stenting; four of them required a third, and three had a fourth stenting. Conclusions: Endoscopic balloon dilatation and stenting are safe and effective means of treatment of anastomotic biliary strictures following liver transplantation.
Açıklama
Anahtar Kelimeler
Cerrahi
Kaynak
Turkish Journal of Gastroenterology
WoS Q Değeri
Scopus Q Değeri
Cilt
17
Sayı
3
