An Update on Endoscopic Management of Post-Liver Transplant Biliary Complications
Clinical Endoscopy
; : 451-463, 2017.
Article
em En
| WPRIM
| ID: wpr-178246
Biblioteca responsável:
WPRO
ABSTRACT
Biliary complications are the most common post-liver transplant (LT) complications with an incidence of 15%–45%. Furthermore, such complications are reported more frequently in patients who undergo a living-donor LT compared to a deceased-donor LT. Most post-LT biliary complications involve biliary strictures, bile leakage, and biliary stones, although many rarer events, such as hemobilia and foreign bodies, contribute to a long list of related conditions. Endoscopic treatment of post-LT biliary complications has evolved rapidly, with new and effective tools improving both outcomes and success rates; in fact, the latter now consistently reach up to 80%. In this regard, conventional endoscopic retrograde cholangiopancreatography remains the preferred initial treatment. However, percutaneous transhepatic cholangioscopy is now central to the management of endoscopy-resistant cases involving complex hilar or multiple strictures with associated stones. Many additional endoscopic tools and techniques—such as the rendezvous method, magnetic compression anastomosis , and peroral cholangioscopy—combined with modified biliary stents have significantly improved the success rate of endoscopic management. Here, we review the current status of endoscopic treatment of post-LT biliary complications and discuss conventional as well as the aforementioned new tools and techniques.
Palavras-chave
Texto completo:
1
Base de dados:
WPRIM
Assunto principal:
Bile
/
Doenças Biliares
/
Stents
/
Incidência
/
Colangiopancreatografia Retrógrada Endoscópica
/
Transplante de Fígado
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Constrição Patológica
/
Coledocolitíase
/
Fístula Anastomótica
/
Corpos Estranhos
Tipo de estudo:
Incidence_studies
/
Prognostic_studies
Limite:
Humans
Idioma:
En
Revista:
Clinical Endoscopy
Ano de publicação:
2017
Tipo de documento:
Article