Abstract
Purpose
Cholestasis due to benign biliary strictures is the most common biliary complication after pediatric split liver transplantation (SLT), decreasing graft survival, but consensus about its management lacks. Percutaneous transhepatic cholangiography, bilioplasty and internal–external biliary drainage (IEBD) are standard treatments. The aim of this report is to present the preliminary experience with a new biodegradable biliary stent in the management of post-SLT biliary strictures.
Materials and Methods
Between September 2020 and April 2021, SLT patients with a single anastomotic benign biliary stricture underwent percutaneous transhepatic implantation of an innovative 10F helical-shaped biodegradable biliary stent, featuring a slow degradation profile, in addition to the standard treatment with bilioplasty and IEBD. The device is unique and the first to be CE-marked for the use in this indication.
Results
Six pediatric patients (4 males; median age 8.6 years, interquartile range 3.7 years) underwent percutaneous stent implantation, without complications nor clinical cholestasis during a median follow-up of 271 days (IQR 120.25). Stent dislodgement occurred in one case.
Conclusion
Preliminary data suggest that implantation of a new biodegradable biliary stent may be considered in the management of post-SLT cholestasis in pediatric patients. Some technical tips are useful during implantation. This device may prolong biliary drainage, potentially relieving the discomfort of long-term IEBD.
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Data Availability
No datasets were generated in this study. All the findings are described in the manuscript. Clinical and radiological data are stored in institutional electronic archives, and they are available upon request to the corresponding author.
Abbreviations
- BDA:
-
Biliodigestive anastomosis
- IEBD:
-
Internal–external biliary drainage
- PTC:
-
Percutaneous transhepatic cholangiography
- SLT:
-
Split liver transplantation
References
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The authors did not receive support from any organization for the submitted work.
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All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by [Paolo Marra], [Francesco Saverio Carbone] and [Ludovico Dulcetta]. The first draft of the manuscript was written by [Paolo Marra], and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.
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Written informed consent was obtained from all patients in this study.
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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. The Human Investigation Committee (IRB) of Bergamo approved this study.
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Marra, P., Carbone, F.S., Dulcetta, L. et al. A New Biodegradable Stent to Improve the Management of Biliary Strictures in Pediatric Split Liver Transplantation. Cardiovasc Intervent Radiol 45, 867–872 (2022). https://doi.org/10.1007/s00270-022-03083-5
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DOI: https://doi.org/10.1007/s00270-022-03083-5