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Response to endoscopic therapy for biliary anastomotic strictures in deceased versus living donor liver transplantation

摘要BACKGROUND:?Endoscopic? therapy? has? been? successful? in?the?management?of?biliary?complications?after?both?deceased?donor? liver? transplantation? (DDLT)? and? living? donor? liver?transplantation? (LDLT).? LDLT? is? thought? to? be? associated?with? higher? rates? of? biliary? complications,? but? there? are? few?studies? comparing? the? success? of? endoscopic? management? of?anastomotic?strictures?between?the?two?groups.?This?study?aims?to?compare?our?experience?in?the?endoscopic?management?of?anastomotic?strictures?in?DDLT?versus?LDLT. <br> METHODS:?This? is? a? retrospective? database? review? of? all?liver? transplant? patients? undergoing? endoscopic? retrograde?cholangiopancreatography? (ERCP)? after? liver? transplantation.?The?frequency?of?anastomotic?stricture?and?the?time?to?develop?and? to? resolve? anastomotic? stricture? were? compared? between?DDLT? and? LDLT.? The? response? of? anastomotic? stricture? to?endoscopic?therapy?was?also?analyzed. <br> RESULTS:?A? total? of? 362? patients? underwent? liver? transplan-tation? between? 2003? and? 2011,? with? 125? requiring? ERCP? to?manage? biliary? complications.? Thirty-three? (9.9%)? cases? of?DDLT? and? 8? (27.6%)? of? LDLT? (P=0.01)? were? found? to? have?anastomotic? stricture.? When? comparing? DDLT? and? LDLT,?there?was?no?difference?in?the?mean?time?to?the?development?of? anastomotic? strictures? (98±17? vs? 172±65? days,? P=0.11),?likelihood?of?response?to?ERCP?[22?(66.7%)?vs?6?(75.0%),?P=0.69],?mean?time?to?the?resolution?of?anastomotic?strictures?(268±77?vs?125±37?days,?P=0.34),?and?the?number?of?ERCPs?required?to?achieve?resolution?(3.9±0.4?vs?4.7±0.9,?P=0.38). <br> CONCLUSIONS:?Endoscopic?therapy?is?effective?in?the?majority?of? biliary? complications? relating? to? liver? transplantation.?Anastomotic? strictures? occur? more? frequently? in? LDLT?compared? with? DDLT,? with? equivalent? endoscopic? treatment?response?and?outcomes?for?both?groups.

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发布时间 2014-12-08(万方平台首次上网日期,不代表论文的发表时间)
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国际肝胆胰疾病杂志(英文版)

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