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CardioVascular and Interventional Radiology

, Volume 39, Issue 6, pp 909–915 | Cite as

Long-Term Efficacy of Percutaneous Internal Plastic Stent Placement for Non-anastomotic Biliary Stenosis After Liver Transplantation

  • Eun Sun Lee
  • Joon Koo HanEmail author
  • Ji-Hyun Baek
  • Suk-Won Suh
  • Ijin Joo
  • Nam-Joon Yi
  • Kwang-Woong Lee
  • Kyung-Suk Suh
Clinical Investigation

Abstract

Purpose

We aimed to evaluate the long-term efficacy of percutaneous management of non-anastomotic biliary stenosis after liver transplantation, using plastic internal biliary stents.

Materials and Methods

This study included 35 cases (28 men, 7 women; mean age: 52.09 ± 8.13 years, range 34–68) in 33 patients who needed repeated interventional procedures because of biliary strictures. After classification of the biliary strictures, we inserted percutaneous biliary plastic stents through the T-tube or percutaneous transhepatic biliary drainage tracts. Stents were exchanged according to percutaneous methods at regular 2- to 6-month intervals. The stents were removed if the condition improved, as observed on cholangiogram as well as based on clinical findings. The median patient follow-up period after initial diagnosis and treatment was 6.04 years (range 0.29–9.95 years). We assessed treatment success rate and patient and graft survival times.

Results

During the follow-up period, 14 patients (14/33, 42.42 %) were successfully treated and were tube-free. The median tube-free time, time without a stent, was 4.13 years (range 1.00–9.01). In contrast, internal plastic stents remained in 9 patients (9/33, 27.27 %) until the last follow-up. These patients had acceptable hepatic function. Among the remaining 10 patients, 3 (3/33, 9.09 %) were lost to regular follow-up and the other 7 (7/33, 21.21 %) patients died. The overall graft loss rate was 20.0 % (7/35). The median time from initial treatment to graft loss was 1.84 years (range 0.42–4.25).

Conclusions

Percutaneous plastic stents placement is technically feasible and clinically useful in patients with multiple biliary stenoses following liver transplantation.

Keywords

Catheter drainage Stenting Bile duct Liver Stenosis Non-vascular interventions 

Abbreviations

AS

Anastomotic strictures

BM

Bilateral multifocal

CO

Confluent

DDLT

Deceased donor liver transplantation

DN

Diffuse necrosis

IHBS

Intrahepatic biliary stricture

LDLT

Living donor liver transplantation

LT

Liver transplantation

NAS

Non-anastomotic intrahepatic stricture

PTBD

Percutaneous transhepatic biliary drainage

Notes

Acknowledgments

Nothing to disclose for all authors.

Compliance with Ethical Standards

Conflict of Interest

All the authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

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Copyright information

© Springer Science+Business Media New York and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2016

Authors and Affiliations

  • Eun Sun Lee
    • 1
    • 2
    • 3
  • Joon Koo Han
    • 1
    • 2
    • 4
    Email author
  • Ji-Hyun Baek
    • 1
    • 2
  • Suk-Won Suh
    • 5
    • 6
  • Ijin Joo
    • 1
    • 2
  • Nam-Joon Yi
    • 6
    • 7
  • Kwang-Woong Lee
    • 6
    • 7
  • Kyung-Suk Suh
    • 6
    • 7
  1. 1.Department of RadiologySeoul National University HospitalSeoulKorea
  2. 2.Department of RadiologySeoul National University College of MedicineSeoulKorea
  3. 3.Department of RadiologyChung-Ang University HospitalSeoulKorea
  4. 4.Institute of Radiation MedicineSeoul National University Medical Research CenterSeoulKorea
  5. 5.Department of SurgeryChung-Ang University HospitalSeoulKorea
  6. 6.Department of SurgerySeoul National University HospitalSeoulKorea
  7. 7.Department of SurgerySeoul National University College of MedicineSeoulKorea

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