Combined Endoscopic and Percutaneous Cholangiography for Biliary Anastomotic Stricture in Adult Right-Lobe Living-Donor Liver Transplantation.

A. Thorat,¹ W.-H. Huang,² C.-J. Yu,² C.-Y. Peng,² H.-R. Yang,¹ C.-C. Yeh,¹ T.-H. Chen,¹ S.-C. Hsu,¹ L.-B. Jeng.¹

¹Organ Transplantation, China Medical University Hospital, Taichung, Taiwan
²Internal Medicine, China Medical University Hospital, Taichung, Taiwan

Meeting: 2017 American Transplant Congress

Abstract number: B207

Keywords: Liver transplantation, Living-related liver donors

Session Information

Session Name: Poster Session B: Liver Retransplantation and Other Complications

Session Type: Poster Session

Date: Sunday, April 30, 2017

Session Time: 6:00pm-7:00pm

Presentation Time: 6:00pm-7:00pm

Location: Hall D1

Background:

Biliary anastomotic stricture isthe most common biliary complication after living donor liver transplantation (LDLT) that may be potentially life threatening if biliary sepsis occurs.Endoscopic retrograde cholangiography (ERC) with balloon dilatation and stent placement is the principal treatment for biliary strictures of duct to duct anastomosis. Percutaneous transhepatic cholangiography (PTC) is an alternative method.The aim of this study was to assess the technical feasibility and clinical outcomes of combined endoscopic and percutaneous therapy for biliary anastomotic stricture in adult right-lobe LDLT with duct to duct anastomosis.

Materials and methods:

Between January 2008 and December 2015, 648 patients receiving right-lobe living donor liver transplantation in our hospital were analyzed. When biliary strictures were suspected, patients underwent ERC first. If ERC failed, PTC and/or combined PTC and ERC were done.

Results:

Eighty-two biliary strictures were diagnosed in 648 recipients (13%; 82/648) after undergoing ERC at an average of 256 (7-1979) days after LDLT. Stricture only and stricture plus leakage were found in 72 and 10 patients, respectively. Among 82 patients (59 male and 23 female) with mean age 52.6 ± 9.6 (24-72) years, 40 patients were successfully treated by ERC, 5 by PTC, and 9 by combined PTC and ERC. In successful ERC with an average of 5.03 ± 2.96 sessions, 11.5 ± 11.0 plastic stents in total and 2.05 + 0.71 stents at each ERC session were placed.Morphology of stricture (pouched shape) was the only factor associated with failed ERC (P < 0.05). During a follow-up period of 976 ± 643 days, four patients receiving ERC developed recurrent stricture.

Conclusions:

Biliary stricture following LDLT is complicated and associated with high mortality. ERC is a feasible first modality. Morphology of stricture is associated with failed ERC. PTC and combined PTC and ERC play complementary roles in patients failing ERC.

CITATION INFORMATION: Thorat A, Huang W.-H, Yu C.-J, Peng C.-Y, Yang H.-R, Yeh C.-C, Chen T.-H, Hsu S.-C, Jeng L.-B. Combined Endoscopic and Percutaneous Cholangiography for Biliary Anastomotic Stricture in Adult Right-Lobe Living-Donor Liver Transplantation. Am J Transplant. 2017;17 (suppl 3).

To cite this abstract in AMA style:

Thorat A, Huang W-H, Yu C-J, Peng C-Y, Yang H-R, Yeh C-C, Chen T-H, Hsu S-C, Jeng L-B. Combined Endoscopic and Percutaneous Cholangiography for Biliary Anastomotic Stricture in Adult Right-Lobe Living-Donor Liver Transplantation. [abstract]. Am J Transplant. 2017; 17 (suppl 3). https://atcmeetingabstracts.com/abstract/combined-endoscopic-and-percutaneous-cholangiography-for-biliary-anastomotic-stricture-in-adult-right-lobe-living-donor-liver-transplantation/. Accessed May 25, 2025.

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