Endoscopic management of bile leaks after liver transplantation: An analysis of two high-volume transplant centers.
United European Gastroenterol J
; 6(1): 89-96, 2018 Feb.
Article
en En
| MEDLINE
| ID: mdl-29435318
ABSTRACT
BACKGROUND:
Bile leak after liver transplantation (LT) is commonly treated with endoscopic retrograde cholangiopancreatography (ERCP); however, there are limited data regarding the optimal treatment strategy.OBJECTIVE:
We aimed to examine the role of ERCP in LT recipients with bile leaks at two large institutions.METHODS:
We reviewed all ERCPs performed in LT recipients with bile leak and duct-to-duct biliary anastomosis at two high-volume transplant centers.RESULTS:
Eighty patients were included. Forty-seven (59%) patients underwent ERCP with plastic stent placement (with or without sphincterotomy) and 33 patients (41%) underwent sphincterotomy alone. Complete resolution was obtained in 94% of the stent group vs. 58% of the sphincterotomy group (p < 0.01). There was no difference in three-month survival among both groups. Percutaneous transhepatic therapy and surgery were required in 4% and 6% in the stent group vs. 12% and 42% in the sphincterotomy group, respectively (p = 0.22 and p < 0.001). The only predictive factor of bile leak resolution was stent placement.CONCLUSION:
ERCP with plastic stent placement is highly successful and more effective than sphincterotomy alone for post-LT bile leak treatment. These results indicate that ERCP and plastic stent placement should be considered the standard of care for the treatment of bile leaks in LT.
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Tipo de estudio:
Prognostic_studies
Idioma:
En
Revista:
United European Gastroenterol J
Año:
2018
Tipo del documento:
Article
País de afiliación:
España