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Transhepatic Balloon Dilatation of Early Biliary Strictures in Pediatric Liver Transplantation: Successful Initial and Mid-Term Outcome

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Abstract

Purpose: To evaluate the initial and mid-term outcomes of transhepatic balloon dilatation for the treatment of early biliary strictures in lateral left-segment liver transplants in young children.

Methods: Between April 1997 and May 2001, seven children aged 9 months to 6 years with nine benign strictures in left-segment liver grafts were treated percutaneously. Sessions of two or three dilations were performed three or four times at average intervals of 10–20 days. In each session, the biliary stenoses were gradually dilated using balloons of 3–7 mm. Follow-up ranged from 12 to 54 months (mean 27 months, median 12 months). Clinical success was defined as resolution of the stenosis, normalization of liver enzymes and lack of clinical symptoms

Results: Technical success was achieved in all nine strictures. Hemobilia occurred in one patient and was successfully treated. On follow-up, all patients had complete clinical recovery with normalization of liver function and imaging of patent bile ducts.

Conclusion: Balloon dilatation is an effective and relatively safe method for the treatment of early biliary strictures in left-segment liver transplantation in young children. We recommend this approach as the initial treatment for early strictures. Metal stents or surgery should be reserved for patients with late appearance of strictures or failure of balloon dilatation.

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References

  1. RW Strong SV Lynch TH Ong et al. (1990) ArticleTitleSuccessful liver transplantation from a living donor to her son N Engl J Med 322 1505–1507 Occurrence Handle1:STN:280:By%2BB2crgsVY%3D Occurrence Handle2336076

    CAS  PubMed  Google Scholar 

  2. H Bismuth D Houssin (1984) ArticleTitleReduced-sized orthotopic livers graft in hepatic transplantation Surgery 95 367–370 Occurrence Handle1:STN:280:BiuC2cjkvFw%3D Occurrence Handle6367125

    CAS  PubMed  Google Scholar 

  3. CE Broelsch PF Whitington JC Emond et al. (1991) ArticleTitleLiver transplantation in children from a living related donor Ann Surg 214 428–437 Occurrence Handle1:STN:280:By2D287isVA%3D Occurrence Handle1953097

    CAS  PubMed  Google Scholar 

  4. K Tanaka S Hemoto Y Tokunga et al. (1993) ArticleTitleSurgical techniques and innovation in living related liver transplantation Ann Surg 217 82–91 Occurrence Handle1:STN:280:ByyC2czktFE%3D Occurrence Handle8424706

    CAS  PubMed  Google Scholar 

  5. SJ Citron LG Martin (1991) ArticleTitleBenign biliary strictures treatment with percutaneous cholangioplasty Radiology 178 339–341 Occurrence Handle1:STN:280:By6C3c3it1w%3D Occurrence Handle1987589

    CAS  PubMed  Google Scholar 

  6. AB Zaijko R Sheng GM Zetti et al. (1995) ArticleTitleTranshepatic balloon dilatation of biliary stricture in liver transplant patients: A 10-year experience J Vasc Interv Radiol 6 79–83 Occurrence Handle7703586

    PubMed  Google Scholar 

  7. EM Ward MJ Kiely TP Maus et al. (1990) ArticleTitleHilar biliary strictures after liver transplantation: Cholangiography and percutaneous treatment Radiology 177 259–263 Occurrence Handle1:STN:280:By%2BA2sfgvVM%3D Occurrence Handle2399328

    CAS  PubMed  Google Scholar 

  8. KH Caron JL Strife DS Babcock et al. (1992) ArticleTitleLeft lobe hepatic transplants: Spectrum of normal imaging findings Am J Radiol 159 497–501 Occurrence Handle1:STN:280:By2A28jmsFI%3D

    CAS  Google Scholar 

  9. D Schindel S Dunn A Casus et al. (2000) ArticleTitleCharacterization and treatment of biliary anastomotic stricture after segmental liver transplantation J Pediat Surg 35 940–942 Occurrence Handle10.1053/jpsu.2000.6932 Occurrence Handle1:STN:280:DC%2BD3cvps1Kgsg%3D%3D Occurrence Handle10873040

    Article  CAS  PubMed  Google Scholar 

  10. A Riber HJ Brambs W Lauchart (1996) ArticleTitleThe radiological management of biliary complications following liver transplantation Cardiovasc Intervent Radiol 19 242–247 Occurrence Handle10.1007/s002709900049 Occurrence Handle8755077

    Article  PubMed  Google Scholar 

  11. TG Heffron JC Emond PF Whitington et al. (1992) ArticleTitleBiliary complications in pediatric liver transplantation: A comparsion of reduced-size and whole grafts Transplantation 53 391–395 Occurrence Handle1:STN:280:By2C2M7jt1Q%3D Occurrence Handle1738934

    CAS  PubMed  Google Scholar 

  12. SJ Schwarzenberg HI Sharo WD Payne DW Hunter H Bjarnason A Humar SA Weisdorf-Schindele RW Gruessner (2002) ArticleTitleBiliary stricture in living-related donor liver transplantation: Management with balloon dilatation Pediatr Transplant 6 132–135 Occurrence Handle10.1034/j.1399-3046.2002.01053.x Occurrence Handle12000469

    Article  PubMed  Google Scholar 

  13. PD Orons AB Zaijko (1994) International procedures in the management of liver transplant complications . Cope (Eds) Current techniques in interventional radiology Current Medicine Philadelphia 1.12–1.19

    Google Scholar 

  14. WL Campbell R Sheng AB Zaijko K Abu-Elmaged AJ Demetris (1994) ArticleTitleIntrahepatic biliary stricture after liver transplantation Radiology 191 735–740 Occurrence Handle1:STN:280:ByuB2c%2FivVE%3D Occurrence Handle8184054

    CAS  PubMed  Google Scholar 

  15. JJ Trambert KM Bron AB Zaijko et al. (1987) ArticleTitlePercutaneous transhepatic balloon dilatation of benign biliary strictures AJR Am J Roentgenol 149 945–948 Occurrence Handle1:STN:280:BieD2cnktl0%3D Occurrence Handle3499800

    CAS  PubMed  Google Scholar 

  16. HA Pitt SL Kaufman J Coleman et al. (1989) ArticleTitleBenign postoperative biliary strictures Ann Surg 210 417–426 Occurrence Handle1:STN:280:By%2BD38rkslQ%3D Occurrence Handle2802831

    CAS  PubMed  Google Scholar 

  17. PR Mueller E Van Sonnenberg JT Ferrucci Jr et al. (1986) ArticleTitleBiliary stricture dilatation: Multicenter review of clinical management in 73 patients Radiology 160 17–22 Occurrence Handle1:STN:280:BimB3svht10%3D Occurrence Handle3715030

    CAS  PubMed  Google Scholar 

  18. HA Pitt T Miyamoto SK Parapatis et al. (1982) ArticleTitleFactors influencing outcome in patients with postoperative biliary strictures Am J Surg 144 14–21 Occurrence Handle10.1016/0002-9610(82)90595-5 Occurrence Handle1:STN:280:Bi2B38fjtVE%3D Occurrence Handle7091522

    Article  CAS  PubMed  Google Scholar 

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Acknowledgment

Presented at the Annual Meeting of the Cardiovascular and Interventional Radiology Society of Europe, Gothenburg, Sweden, September 2001.

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Authors and Affiliations

  1. Department of Radiology, Rabin Medical Center, Beilinson Campus, Petah Tiqva 49100, Israel

    Alexander Belenky, Eli Atar & Gil N. Bachar

  2. Department of Transplantation, Rabin Medical Center, Beilinson Campus, Petah Tiqva 49100, Israel

    Eytan Mor & Nathan Bar-Nathan

  3. Department of Radiology, Hillel-Yaffe Medical Center, Hadera, Israel

    Gabriel Bartal

  4. Institute of Pediatric Gastroenterology, Schneider Children’s Medical Center of Israel and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

    Riki Shapiro

Authors
  1. Alexander Belenky
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  2. Eytan Mor
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  3. Gabriel Bartal
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  4. Eli Atar
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  5. Riki Shapiro
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  6. Nathan Bar-Nathan
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  7. Gil N. Bachar
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Corresponding author

Correspondence to Gil N. Bachar.

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Belenky, A., Mor, E., Bartal, G. et al. Transhepatic Balloon Dilatation of Early Biliary Strictures in Pediatric Liver Transplantation: Successful Initial and Mid-Term Outcome. CVIR 27, 491–494 (2004). https://doi.org/10.1007/s00270-003-2675-0

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