Endoscopic Management of Benign Biliary Strictures After Liver Transplantation

Biliary strictures represent some of the most frequent complications encountered after orthotopic liver transplantation. They comprise an array of biliary abnormalities with variations in anatomical location, clinical presentation, and different pathogenesis. Magnetic resonance cholangiography repre...

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Bibliographic Details
Published in:Liver transplantation 2019-02, Vol.25 (2), p.323-335
Main Authors: Larghi, Alberto, Tringali, Andrea, Rimbaş, Mihai, Barbaro, Federico, Perri, Vincenzo, Rizzatti, Gianenrico, Gasbarrini, Antonio, Costamagna, Guido
Format: Article
Language:English
Subjects:
Anastomosis
Anastomosis, Surgical - adverse effects
Balloon treatment
Biliary Tract - diagnostic imaging
Biliary Tract - pathology
Biliary Tract Surgical Procedures - instrumentation
Biliary Tract Surgical Procedures - methods
Cholangiography
Cholangiopancreatography, Endoscopic Retrograde - instrumentation
Cholangiopancreatography, Endoscopic Retrograde - methods
Cholestasis - diagnostic imaging
Cholestasis - etiology
Cholestasis - surgery
Constriction, Pathologic - diagnostic imaging
Constriction, Pathologic - etiology
Constriction, Pathologic - surgery
Endoscopy
Humans
Implants
Liver transplantation
Liver Transplantation - adverse effects
Liver transplants
Magnetic Resonance Imaging
Sphincterotomy, Endoscopic - instrumentation
Sphincterotomy, Endoscopic - methods
Stents
Stricture
Treatment Outcome
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Summary:Biliary strictures represent some of the most frequent complications encountered after orthotopic liver transplantation. They comprise an array of biliary abnormalities with variations in anatomical location, clinical presentation, and different pathogenesis. Magnetic resonance cholangiography represents the most accurate noninvasive imaging test that can provide detailed imaging of the whole biliary system—below and above the anastomosis. It is of particular value in those harboring complex hilar or intrahepatic strictures, offering a detailed roadmap for planning therapeutic procedures. Endoscopic therapy of biliary strictures usually requires biliary sphincterotomy plus balloon dilation and stent placement. However, endoscopic management of nonanastomotic biliary strictures is much more complex and challenging as compared with anastomotic biliary strictures. The present article is a narrative review presenting the results of endoscopic treatment of biliary strictures occurring after liver transplantation, describing the different strategies based on the nature of the stricture and summarizing their outcomes.
ISSN:1527-6465
1527-6473
DOI:10.1002/lt.25358