Percutaneous transhepatic cholangioscopy for biliary complications after liver transplantation: a single center experience. (31st August 2016)

• Record Type: Journal Article
• Authors: Nam, Kwangwoo; Lee, Sung Koo; Song, Tae Jun; Park, Do Hyun; Lee, Sang Soo; Seo, Dong‐Wan; Kim, Myung‐Hwan
• Is Part Of: Journal of hepato-biliary-pancreatic sciences. Volume 23:Number 10(2016)
• Page Start: 650
• Page End: 657
• Publication Date: 2016-08-31
• Subjects: Biliary tract surgical procedure -- Complications -- Liver transplantation -- Percutaneous transhepatic cholangioscopy; Liver -- Diseases -- Periodicals; Biliary tract -- Diseases -- Periodicals; Pancreas -- Diseases -- Periodicals; 617.556
• DOI: 10.1002/jhbp.388
• Languages: English
• ISSNs: 1868-6974

Abstract

Abstract: Background: Some biliary complications after liver transplantation (LT) are difficult to manage by endoscopic or radiologic intervention alone. In these cases, percutaneous transhepatic cholangioscopy (PTCS) can be used as an adjuvant option. Methods: Patients who underwent PTCS for post‐LT biliary complications between August 1992 and January 2016 were retrospectively reviewed. Results: Fifteen patients underwent PTCS for post‐LT biliary complications. The median age at LT was 47 years and 11 patients were male. Indications for LT were as follows: decompensated liver cirrhosis ( n = 9), hepatocellular carcinoma ( n = 5), and acute fulminant liver failure ( n = 1). Single living donor was common ( n = 11) and duct‐to‐duct anastomosis was performed in 11 patients. The median age at PTCS was 52 years and indications for PTCS were as follows: intrahepatic duct stone ( n = 10), common bile duct stone ( n = 1), biliary cast ( n = 1), and biliary stricture ( n = 3). There were no significant PTCS‐related morbidity and mortality. However, four patients (26.7%) needed additional radiologic intervention ( n = 2) or surgery ( n = 2) after PTCS. Conclusions: Percutaneous transhepatic cholangioscopy in conjunction with endoscopic and radiologic interventions can aid in managing post‐LT biliary complications and avoiding reoperation. Abstract : Highlight Nam and colleagues retrospectively reviewed patients who underwent percutaneous transhepatic cholangioscopy for biliary complications after liver transplantation. As the demand for living donor liver transplantation increases, intractable biliary complications are expected to increase. Percutaneous transhepatic cholangioscopy allows direct visualization of the intraductal biliary structures, making it a useful adjuvant option.