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Outcomes of management for biliary stricture after living donor liver transplantation with hepaticojejunostomy using short-type double-balloon enteroscopy

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Abstract

Background and aims

To evaluate the outcomes of management for biliary stricture (BS) after living donor liver transplantation (LDLT) using short-type double-balloon enteroscopy.

Methods

This study retrospectively evaluated 20 patients who underwent endoscopic retrograde cholangiography using short-type double-balloon enteroscopy (sDB-ERC) upon suspicion of BS after LDLT with hepaticojejunal (HJ) reconstruction at Okayama University Hospital.

Results

Scope insertion to the HJ site and sDB-ERC succeeded in 85 % (17/20) and 82.4 % (14/17) of patients, respectively. Of 14 patients who required treatment for BS, 11 were successfully treated using sDB-ERC, and 3 were successfully treated using sDB-ERC and rendezvous procedures. Adverse events occurred in 2.9 % of all sessions (2/68). After resolution of BS, 7 patients (50 %) experienced a recurrence. Of these, 6 (85.7 %) were treated with only balloon dilation, and 1 (14.3 %) was treated with both balloon dilation and stent deployment (P = 0.029).

Conclusions

sDB-ERC is a useful procedure for diagnosis and treatment for BS after LDLT with HJ reconstruction. Balloon dilation combined with stent deployment might be recommended for definite resolution of BS.

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Authors and Affiliations

  1. Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama City, Okayama, 700-8558, Japan

    Takeshi Tomoda, Koichiro Tsutsumi, Hironari Kato, Sho Mizukawa, Syuntaro Yabe, Yutaka Akimoto, Hiroyuki Seki, Daisuke Uchida, Kazuyuki Matsumoto, Naoki Yamamoto, Shigeru Horiguchi & Hiroyuki Okada

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  1. Takeshi Tomoda
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  2. Koichiro Tsutsumi
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  3. Hironari Kato
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  4. Sho Mizukawa
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  5. Syuntaro Yabe
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  6. Yutaka Akimoto
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  7. Hiroyuki Seki
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  8. Daisuke Uchida
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  9. Kazuyuki Matsumoto
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  10. Naoki Yamamoto
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  11. Shigeru Horiguchi
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  12. Hiroyuki Okada
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Correspondence to Takeshi Tomoda.

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Disclosures

Takeshi Tomoda, Koichiro Tsutsumi, Hironari Kato, Sho Mizukawa, Syuntaro Yabe, Yutaka Akimoto, Hiroyuki Seki, Daisuke Uchida, Kazuyuki Matsumoto, Naoki Yamamoto, Shigeru Horiguchi, and Hiroyuki Okada have no conflicts of interest or financial ties to disclose.

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Tomoda, T., Tsutsumi, K., Kato, H. et al. Outcomes of management for biliary stricture after living donor liver transplantation with hepaticojejunostomy using short-type double-balloon enteroscopy. Surg Endosc 30, 5338–5344 (2016). https://doi.org/10.1007/s00464-016-4886-x

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