Biliary stricture after adult right-lobe living-donor liver transplantation with duct-to-duct anastomosis

Long-term outcome and its related factors after endoscopic treatment

Jae Hyuck Chang, In Seok Lee, Jong Young Choi, Seung Kyoo Yoon, Dong Goo Kim, Ng Kyoung You, Ho Jong Chun, DongKi Lee, Myung Gyu Choi, In Sik Chung

Research output: Contribution to journalArticle

50 Citations (Scopus)

Abstract

Background/Aims: Biliary stricture is the most common and important complication after right-lobe living-donor liver transplantation (RL-LDLT) with duct-toduct biliary anastomosis. This study evaluated the efficacy and long-term outcome of endoscopic treatment for biliary stricture after LDLT, with the aim of identifying the factors that influence the outcome. Methods: Three hundred and thirty-nine adults received RL-LDLTs with duct-to-duct biliary anastomosis between January 2000 and May 2008 at Kangnam St. Mary's Hospital. Endoscopic retrograde cholangiography (ERC) was performed in 113 patients who had biliary stricture after LDLT. We evaluated the incidence of post-LDLT biliary stricture and the long-term outcome of endoscopic treatment for biliary stricture. The factors related to the outcome were analyzed. Results: Biliary strictures developed in 121 (35.7%) patients, 95 (78.5%) of them within 1 year of surgery. The mean number of ERCs performed per patient was 3.2 (range, 1 to 11). The serum biochemical markers decreased significantly after ERC (p<0.001). Stent insertion or stricture dilatation during ERC was successful in 90 (79.6%) patients. After a median follow-up period of 33 months from the first successful treatment with ERC, 48 (42.5%) patients achieved treatment success and 12 (10.6%) patients remained under treatment. The factors related to the outcome of endoscopic treatment were nonanastomotic stricture and stenosis of the hepatic artery (p=0.016). Conclusions: Endoscopic treatment is efficacious and has an acceptable long-term outcome in the management of biliary strictures related to RL-LDLT with duct-to-duct biliary anastomosis. Nonanastomotic stricture and stenosis of the hepatic artery are correlated with a worse outcome of endoscopic treatment.

Original languageEnglish
Pages (from-to)226-233
Number of pages8
JournalGut and Liver
Volume4
Issue number2
DOIs
Publication statusPublished - 2010 Jun 1

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Living Donors
Liver Transplantation
Pathologic Constriction
Cholangiography
Therapeutics
Hepatic Artery
Biomarkers
Stents
Dilatation

All Science Journal Classification (ASJC) codes

  • Hepatology
  • Gastroenterology

Cite this

Chang, Jae Hyuck ; Lee, In Seok ; Choi, Jong Young ; Yoon, Seung Kyoo ; Kim, Dong Goo ; You, Ng Kyoung ; Chun, Ho Jong ; Lee, DongKi ; Choi, Myung Gyu ; Chung, In Sik. / Biliary stricture after adult right-lobe living-donor liver transplantation with duct-to-duct anastomosis : Long-term outcome and its related factors after endoscopic treatment. In: Gut and Liver. 2010 ; Vol. 4, No. 2. pp. 226-233.
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abstract = "Background/Aims: Biliary stricture is the most common and important complication after right-lobe living-donor liver transplantation (RL-LDLT) with duct-toduct biliary anastomosis. This study evaluated the efficacy and long-term outcome of endoscopic treatment for biliary stricture after LDLT, with the aim of identifying the factors that influence the outcome. Methods: Three hundred and thirty-nine adults received RL-LDLTs with duct-to-duct biliary anastomosis between January 2000 and May 2008 at Kangnam St. Mary's Hospital. Endoscopic retrograde cholangiography (ERC) was performed in 113 patients who had biliary stricture after LDLT. We evaluated the incidence of post-LDLT biliary stricture and the long-term outcome of endoscopic treatment for biliary stricture. The factors related to the outcome were analyzed. Results: Biliary strictures developed in 121 (35.7{\%}) patients, 95 (78.5{\%}) of them within 1 year of surgery. The mean number of ERCs performed per patient was 3.2 (range, 1 to 11). The serum biochemical markers decreased significantly after ERC (p<0.001). Stent insertion or stricture dilatation during ERC was successful in 90 (79.6{\%}) patients. After a median follow-up period of 33 months from the first successful treatment with ERC, 48 (42.5{\%}) patients achieved treatment success and 12 (10.6{\%}) patients remained under treatment. The factors related to the outcome of endoscopic treatment were nonanastomotic stricture and stenosis of the hepatic artery (p=0.016). Conclusions: Endoscopic treatment is efficacious and has an acceptable long-term outcome in the management of biliary strictures related to RL-LDLT with duct-to-duct biliary anastomosis. Nonanastomotic stricture and stenosis of the hepatic artery are correlated with a worse outcome of endoscopic treatment.",
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Biliary stricture after adult right-lobe living-donor liver transplantation with duct-to-duct anastomosis : Long-term outcome and its related factors after endoscopic treatment. / Chang, Jae Hyuck; Lee, In Seok; Choi, Jong Young; Yoon, Seung Kyoo; Kim, Dong Goo; You, Ng Kyoung; Chun, Ho Jong; Lee, DongKi; Choi, Myung Gyu; Chung, In Sik.

In: Gut and Liver, Vol. 4, No. 2, 01.06.2010, p. 226-233.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Biliary stricture after adult right-lobe living-donor liver transplantation with duct-to-duct anastomosis

T2 - Long-term outcome and its related factors after endoscopic treatment

AU - Chang, Jae Hyuck

AU - Lee, In Seok

AU - Choi, Jong Young

AU - Yoon, Seung Kyoo

AU - Kim, Dong Goo

AU - You, Ng Kyoung

AU - Chun, Ho Jong

AU - Lee, DongKi

AU - Choi, Myung Gyu

AU - Chung, In Sik

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AB - Background/Aims: Biliary stricture is the most common and important complication after right-lobe living-donor liver transplantation (RL-LDLT) with duct-toduct biliary anastomosis. This study evaluated the efficacy and long-term outcome of endoscopic treatment for biliary stricture after LDLT, with the aim of identifying the factors that influence the outcome. Methods: Three hundred and thirty-nine adults received RL-LDLTs with duct-to-duct biliary anastomosis between January 2000 and May 2008 at Kangnam St. Mary's Hospital. Endoscopic retrograde cholangiography (ERC) was performed in 113 patients who had biliary stricture after LDLT. We evaluated the incidence of post-LDLT biliary stricture and the long-term outcome of endoscopic treatment for biliary stricture. The factors related to the outcome were analyzed. Results: Biliary strictures developed in 121 (35.7%) patients, 95 (78.5%) of them within 1 year of surgery. The mean number of ERCs performed per patient was 3.2 (range, 1 to 11). The serum biochemical markers decreased significantly after ERC (p<0.001). Stent insertion or stricture dilatation during ERC was successful in 90 (79.6%) patients. After a median follow-up period of 33 months from the first successful treatment with ERC, 48 (42.5%) patients achieved treatment success and 12 (10.6%) patients remained under treatment. The factors related to the outcome of endoscopic treatment were nonanastomotic stricture and stenosis of the hepatic artery (p=0.016). Conclusions: Endoscopic treatment is efficacious and has an acceptable long-term outcome in the management of biliary strictures related to RL-LDLT with duct-to-duct biliary anastomosis. Nonanastomotic stricture and stenosis of the hepatic artery are correlated with a worse outcome of endoscopic treatment.

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