Journal of Gastroenterology

, Volume 48, Issue 9, pp 1097–1104

Endoscopic stent placement above the intact sphincter of Oddi for biliary strictures after living donor liver transplantation

Authors

  • Akira Kurita
    • Department of Gastroenterology and HepatologyKyoto University Graduate School of Medicine
  • Yuzo Kodama
    • Department of Gastroenterology and HepatologyKyoto University Graduate School of Medicine
  • Ryuki Minami
    • Department of Gastroenterology and HepatologyKyoto University Graduate School of Medicine
  • Yojiro Sakuma
    • Department of Gastroenterology and HepatologyKyoto University Graduate School of Medicine
  • Katsutoshi Kuriyama
    • Department of Gastroenterology and HepatologyKyoto University Graduate School of Medicine
  • Wataru Tanabe
    • Department of Gastroenterology and HepatologyKyoto University Graduate School of Medicine
  • Yuji Ohta
    • Department of Gastroenterology and HepatologyKyoto University Graduate School of Medicine
  • Takahisa Maruno
    • Department of Gastroenterology and HepatologyKyoto University Graduate School of Medicine
  • Masahiro Shiokawa
    • Department of Gastroenterology and HepatologyKyoto University Graduate School of Medicine
  • Yugo Sawai
    • Department of Gastroenterology and HepatologyKyoto University Graduate School of Medicine
  • Norimitsu Uza
    • Department of Gastroenterology and HepatologyKyoto University Graduate School of Medicine
  • Shujiro Yazumi
    • Digestive Disease CenterKitano Hospital
  • Atsushi Yoshizawa
    • Department of Hepato-Pancreato-Biliary Surgery and TransplantationKyoto University
  • Shinji Uemoto
    • Department of Hepato-Pancreato-Biliary Surgery and TransplantationKyoto University
    • Department of Gastroenterology and HepatologyKyoto University Graduate School of Medicine
Original Article—Liver, Pancreas, and Biliary Tract

DOI: 10.1007/s00535-012-0705-x

Cite this article as:
Kurita, A., Kodama, Y., Minami, R. et al. J Gastroenterol (2013) 48: 1097. doi:10.1007/s00535-012-0705-x

Abstract

Background and study aims

Biliary complications are one of the most serious morbidities after liver transplantation. Inside-stent is a plastic stent placed above the sphincter of Oddi without endoscopic sphincterotomy against biliary strictures. Our aims were to analyze the long-term efficacy of inside-stent placement in patients with biliary stricture after living donor liver transplantation.

Patients and methods

Ninety-four patients who experienced biliary stricture that employed duct-to-duct reconstruction were treated with inside-stent placement. Treatment outcomes, including stricture resolution, recurrence, inside-stent patency, and morbidity rate were evaluated retrospectively.

Results

Ninety-two patients could be evaluated. Resolution of stricture was eventually observed in 81 of 92 patients with an average of 1.4 sessions of endoscopic retrograde cholangiography. Of the 81 patients who achieved the resolution of the stricture, recurrent biliary stricture that required intervention occurred in 8 patients. Conversely, stricture remission was achieved 73 patients (90.1 %) during 53 months follow-up after stent removal. Median duration of patency of the initial stent was 189 (range 2–1228) days. Stent dislocation occurred in 10 patients. Adverse event related to inside-stent placement was pancreatitis in 18 cases (mild 13, moderate 5).

Conclusions

Inside-stent placement achieved long-term patency and high remission rate in patients with biliary stricture after liver transplantation.

Keywords

Biliary drainageLiving donor liver transplantationStrictureInside-stent

Abbreviations

LDLT

Living donor liver transplantation

RYHJ

Roux-en-Y hepaticojejunostomy

DDLT

Deceased donor liver transplantation

PTBD

Percutaneous transhepatic biliary drainage

ES

Endoscopic sphincterotomy

ERC

Endoscopic retrograde cholangiography

NAS

Non-anastomotic stricture

Copyright information

© Springer Japan 2013