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Anastomotic biliary strictures after liver transplantation: Causes and consequences
Liver transplantation, 2006-05, Vol.12 (5), p.726-735
Verdonk, Robert C.
Buis, Carlijn I.
Porte, Robert J.
van der Jagt, Eric J.
Limburg, Abraham J.
van den Berg, Aad P.
Slooff, Maarten J.H.
Peeters, Paul M.J.G.
de Jong, Koert P.
Kleibeuker, Jan H.
Haagsma, Elizabeth B.
2006
Details
Autor(en) / Beteiligte
Verdonk, Robert C.
Buis, Carlijn I.
Porte, Robert J.
van der Jagt, Eric J.
Limburg, Abraham J.
van den Berg, Aad P.
Slooff, Maarten J.H.
Peeters, Paul M.J.G.
de Jong, Koert P.
Kleibeuker, Jan H.
Haagsma, Elizabeth B.
Titel
Anastomotic biliary strictures after liver transplantation: Causes and consequences
Ist Teil von
Liver transplantation, 2006-05, Vol.12 (5), p.726-735
Ort / Verlag
Hoboken: Wiley Subscription Services, Inc., A Wiley Company
Erscheinungsjahr
2006
Link zum Volltext
Quelle
Wiley Online Library - AutoHoldings Journals
Beschreibungen/Notizen
We retrospectively studied the prevalence, presentation, results of treatment, and graft and patient survival of grafts developing an anastomotic biliary stricture (AS) in 531 adult liver transplantations performed between 1979 and 2003. Clinical and laboratory information was obtained from the hospital files, and radiological studies were re‐evaluated. Twenty‐one possible risk factors for the development of AS (variables of donor, recipient, surgical procedure, and postoperative course) were analyzed in a univariate and stepwise multivariate model. Forty‐seven grafts showed an anastomotic stricture: 42 in duct‐to‐duct anastomoses, and 5 in hepaticojejunal Roux‐en‐Y anastomoses. The cumulative risk of AS after 1, 5, and 10 years was 6.6%, 10.6%, and 12.3% respectively. Postoperative bile leakage (P = 0.001), a female donor/male recipient combination (P = 0.010), and the era of transplantation (P = 0.006) were independent risk factors for the development of an AS. In 47% of cases, additional (radiologically minor) nonanastomotic strictures were diagnosed. All patients were successfully treated by 1 or more treatment modalities. As primary treatment, endoscopic retrograde cholangiopancreaticography (ERCP) was successful in 24 of 36 (67%) cases and percutaneous transhepatic cholangiodrainage in 4 of 11 (36%). In the end 15 patients (32%) were operated, all with long‐term success. AS presenting more than 6 months after transplantation needed more episodes of stenting by ERCP, and more stents per episode compared to those presenting within 6 months and recurred more often. Graft and patient survival were not impaired by AS. Liver Transpl 12:726–735, 2006. © 2006 AASLD.
Sprache
Englisch
Identifikatoren
ISSN: 1527-6465
eISSN: 1527-6473
DOI: 10.1002/lt.20714
Titel-ID: cdi_proquest_miscellaneous_67905743
Format
–
Schlagworte
Adolescent
,
Adult
,
Anastomosis, Surgical - adverse effects
,
Cholangiopancreatography, Endoscopic Retrograde
,
Cholestasis - diagnostic imaging
,
Cholestasis - epidemiology
,
Cholestasis - etiology
,
Cholestasis - therapy
,
Endoscopy
,
Female
,
Graft Survival
,
Humans
,
Liver Transplantation - adverse effects
,
Liver Transplantation - mortality
,
Male
,
Middle Aged
,
Prevalence
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