Endo-therapies for biliary duct-to-duct anastomotic stricture after liver transplantation: Outcomes of a nationwide survey.
Liver Int
; 39(7): 1355-1362, 2019 07.
Article
em En
| MEDLINE
| ID: mdl-30500104
ABSTRACT
BACKGROUND:
The most appropriate endo-therapeutic approach to biliary anastomotic strictures is yet to be defined.AIM:
To retrospectively report on the endo-therapy of duct-to-duct anastomotic strictures during 2013 in Italy.METHODS:
Data were collected from 16 Endoscopy Units at the Italian Liver Transplantation Centers (BASALT study group).RESULTS:
Complete endo-therapy and follow-up data are available for 181 patients 101 treated with plastic multistenting, 26 with fully covered self-expandable metal stenting and 54 with single stenting. Radiological success was achieved for 145 patients (80%), that is, 88% of plastic multistenting, 88% of self-expandable metal stenting and 61% of single stenting (P < 0.001 vs plastic multistenting; P < 0.05 vs self-expandable metal stenting). After first-line endo-therapy failure, the patients underwent a second-line endo-therapy with plastic multistenting for 25%, fully covered self-expandable metal stenting for 53% and single stenting for 22% of cases, and radiological success was achieved for 84%, that is, 100%, 85% and 63% with plastic multistenting, self-expandable metal stenting and single stenting (P < 0.05 vs plastic multistenting or self-expandable metal stenting) respectively. Procedure-related complications occurred in 7.8% of endoscopic retrograde cholangiopancreatographies. Overall, clinical success was achieved in 87% of patients after a median follow-up of 25 months.CONCLUSION:
Plastic multistenting is confirmed as the preferred first-line treatment, while fully covered self-expandable metal stenting as rescue option for biliary anastomotic strictures. Single stenting has sub-optimal results and should be abandoned.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Stents
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Colangiopancreatografia Retrógrada Endoscópica
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Transplante de Fígado
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Constrição Patológica
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Stents Metálicos Autoexpansíveis
País/Região como assunto:
Europa
Idioma:
En
Ano de publicação:
2019
Tipo de documento:
Article
País de afiliação:
Itália