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Endoscopic Therapy of Bile Duct Strictures After Liver Transplant.

H. Woller, P. Mantry, A. Mejia, S. Cheng, C. Fasola.

Gastroenterolgy and Hepatology, Methodist Dallas Medical Center, Dallas, TX

Meeting: 2017 American Transplant Congress

Abstract number: B206

Keywords: Liver transplantation, Post-operative complications

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 and Aims: Common Bile Duct Strictures (CBDS) are a significant source of morbidity after liver transplantation (LT) We report our outcomes of endoscopic treatment in CBDS after LT and factors affecting success.

Methods: We collected de-identified data on patients undergoing endoscopic therapy for CBDS with at least 6 months follow up from January 2004 to November 2016. Demographics, etiology of liver disease, transplant/procedure details, complications and survival data were collected. Patency rate was calculated as the number of procedures required to resolve the CBDS. Endoscopic failure was defined by the need for surgical revision despite endotherapy.

Results: 213 procedures were performed with 143 stents placed in 51 patients. The median age was 58y. Median time from transplant to first ERCP for suspected CBDS was 49 days (avg 224 days). 97 plastic stents and 46 SEMS were placed. An average of 3.7 (median 3) stenting procedures were needed for stricture resolution. The success rate of endotherapy was 83%; 8 patients required surgery. Cold ischemia time (CIT) of the donor organ did not appear to affect the ability to endoscopically treat CBDS. Differences in patients successfully treated with endotherapy vs those failing endotherapy are outlined in Table 1.

Conclusion: We report a large single center experience of endotherapy using a combination of SEMS/plastic stents to treat post-transplant CBDS. Endotherapy was successful 83% of the time with a median of 3 procedures per patient. Post-transplant CBDS appear to be effectively treated with endotherapy

CHARACTERISTICS ENDOTHERAPY

(pts/procedures)

(43/189)

ENDOTHERAPY + SURGERY

(pts/procedures)

(8/24)

AGE (median)
Recipient/Donor age 58/43 59/46
SEX (%)
Male/Female 62.8/37.2 62.5/37.5
TRANSPLANT DATA
OLTx/LKTx 39/4 8/0
Donor type (DBD/DCD) 42/1 7/1
Cold ischemia time (CIT) 352 312
ERCP DATA
Tx to ERCP (median days) 33 63
# stents (plastic/metal) 84/38 13/8
# stents/patient (median) 2 1.5
Patency rate (median) 3 –
Patency duration (median mos) 20 –
COMPLICATIONS (% of procedures)
Stent dysfunction 25.9 33.3
Cholangitis 2.1 0
Death 1.4 0

CITATION INFORMATION: Woller H, Mantry P, Mejia A, Cheng S, Fasola C. Endoscopic Therapy of Bile Duct Strictures After Liver Transplant. Am J Transplant. 2017;17 (suppl 3).

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To cite this abstract in AMA style:

Woller H, Mantry P, Mejia A, Cheng S, Fasola C. Endoscopic Therapy of Bile Duct Strictures After Liver Transplant. [abstract]. Am J Transplant. 2017; 17 (suppl 3). https://atcmeetingabstracts.com/abstract/endoscopic-therapy-of-bile-duct-strictures-after-liver-transplant/. Accessed May 11, 2025.

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