Biliary strictures are one of the most common complications following liver transplantation, with an incidence of 6% to 34%.
Endoscopic techniques have been successfully used to treat biliary complications.
However, the long-term efficacy and safety of this treatment option has not yet been fully elucidated.
Dr Ivo Graziadei and colleagues performed a prospective study on the efficacy and safety of endoscopic management of biliary complications after liver transplants.
The research team assessed its impact on long-term patient and graft survival.
Biliary strictures were suspected in the presence of elevated liver parameters and/or abnormal abdominal sonography.
|77% of patients with anastomotic strictures had long-term success|
The team diagnosed the strictures by endoscopic retrograde cholangiography.
The mean follow-up was 40 months after first endoscopic retrograde cholangiography.
Between 1992 and 2003, a total of 515 patients underwent liver transplantation.
The research team diagnosed biliary complications in16% of patients.
The team found anastomotic strictures alone in 13% and nonanastomotic strictures in 14% of patients.
The researchers observed long-term success in 77% of patients with anastomotic strictures.
In patients with nonanastomotic strictures, partial long-term responses could be achieved in 63% of patients.
The team noted that 6% of patients required a percutaneous, and 7% a surgical approach.
Dr Graziadei's team concluded, “The long-term outcome for patients with post-liver transplant biliary strictures after endoscopic treatment is excellent, especially for patients with anastomotic strictures.”
“Development of non-anastomotic strictures reduces graft but not patient survival after endoscopic therapy.”