Percutaneous Patency Recovery and Biodegradable Stent Placement in a Totally Occluded Hepaticojejunostomy After Paediatric Living Donor Liver Transplantation
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Biliary complications after living donor liver transplantation (LDLT) cause severe morbidity and mortality, with biliary anastomotic stricture being the most common form of presentation. Surgical revision is risky, and it is avoided whenever possible. When a Roux-en-Y hepaticojejunostomy (RYHJ) is used for bilioenteric reconstruction, endoscopic approach is more difficult, if not impracticable. Therefore, percutaneous approach remains as a first-line treatment in these patients. In this case presentation, a percutaneous approach was used to recover patency in an intractable, totally occluded RYHJ stricture in an LDLT paediatric recipient, using a Rösch-Uchida needle to access to the collapsed jejunal loop from the bile duct. Once recanalization of the RYHJ was achieved, a biodegradable stent was placed with middle-term patency at follow-up.
KeywordsHepaticojejunostomy stricture Biodegradable stents Biliary stents Interventional radiology
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Conflict of interest
On behalf of all authors, the corresponding author states that there is no conflict of interest.
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 Declaration of Helsinki and its later amendments or comparable ethical standards.
Informed consent and consent for publication were obtained from the patient’s parents.
- 4.Imamine R, Shibata T, Yabuta M, Shinozuka K, Kataoka M, Isoda H, et al. Long-term outcome of percutaneous biliary interventions for biliary anastomotic stricture in pediatric patients after living donor liver transplantation with Roux-en-Y hepaticojejunostomy. J Vasc Interv Radiol. 2015;26:1852–9.CrossRefGoogle Scholar
- 6.Czerwonko ME, Huespe P, Mazza O, de Santibanes M, Sanchez-Claria R, Pekolj J, et al. Percutaneous biliary balloon dilation: impact of an institutional three-session protocol on patients with benign anastomotic strictures of hepatojejunostomy. Dig Surg. 2017. https://doi.org/10.1159/000480246.Google Scholar