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Endoscopic management of biliary strictures after liver transplantation.
| Content Provider | Semantic Scholar |
|---|---|
| Author | Williams, Emmanuelle D. Draganov, Peter |
| Copyright Year | 2009 |
| Abstract | Bile duct strictures remain a major source of morbidity after orthotopic liver transplantation (OLT). Biliary strictures are classified as anastomotic or non-anastomotic strictures according to location and are defined by distinct clinical behaviors. Anastomotic strictures are localized and short. The outcome of endoscopic treatment for anastomotic strictures is excellent. Non-anastomotic strictures often result from ischemic and immunological events, occur earlier and are usually multiple and longer. They are characterized by a far less favorable response to endoscopic management, higher recurrence rates, graft loss and need for retransplantation. Living donor OLT patients present a unique set of challenges arising from technical factors, and stricture risk for both recipients and donors. Endoscopic treatment of living donor OLT patients is less promising. Current endoscopic strategies for biliary strictures after OLT include repeated balloon dilations and placement of multiple side-by-side plastic stents. Lifelong surveillance is required in all types of strictures. Despite improvements in incidence and long term outcomes with endoscopic management, and a reduced need for surgical treatment, the impact of strictures on patients after OLT is significant. Future considerations include new endoscopic technologies and improved stents, which could potentially allow for a decreased number of interventions, increased intervals before retreatment, and decreased reliance on percutaneous and surgical modalities. This review focuses on the role of endoscopy in biliary strictures, one of the most common biliary complications after OLT. |
| Starting Page | 30 |
| Ending Page | 49 |
| Page Count | 20 |
| File Format | PDF HTM / HTML |
| Alternate Webpage(s) | https://wiki.uchicago.edu/download/attachments/32702633/endoscopic_comp_World_J_Surg_2009.pdf |
| PubMed reference number | 19673012v1 |
| Volume Number | 15 |
| Issue Number | 30 |
| Journal | World journal of gastroenterology |
| Language | English |
| Access Restriction | Open |
| Subject Keyword | Anastomosis - action Balloon Dilatation Behavior Bile duct structure Biliary Tract Diseases Biliary cirrhosis Biliary tract structure Classification Dilate procedure Endoscopic dilatation Imagery Intestines Intestines, Small Intrahepatic Cholestasis Morbidity - disease rate Pathological Dilatation Patients Procurement Retreatments Sensorineural Hearing Loss (disorder) Small Intestinal Wall Tissue Stenosis Stent, device Structure of anatomic arteriovenous anastomosis Surgical Management Transplantation of liver biliary stricture orthotopic liver transplant retransplantation |
| Content Type | Text |
| Resource Type | Article |
