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- Title
Treatment of Non-Anastomotic Biliary Strictures after Liver Transplantation: How Effective Is Our Current Treatment Strategy?
- Authors
Michael, Florian A.; Friedrich-Rust, Mireen; Erasmus, Hans-Peter; Graf, Christiana; Ballo, Olivier; Knabe, Mate; Walter, Dirk; Steup, Christoph D.; Mücke, Marcus M.; Mücke, Victoria T.; Peiffer, Kai H.; Görgülü, Esra; Mondorf, Antonia; Bechstein, Wolf O.; Filmann, Natalie; Zeuzem, Stefan; Bojunga, Jörg; Finkelmeier, Fabian
- Abstract
Background: Non-anastomotic biliary strictures (NAS) are a common cause of morbidity and mortality after liver transplantation. Methods: All patients with NAS from 2008 to 2016 were retrospectively analyzed. The success rate and overall mortality of an ERCP-based stent program (EBSP) were the primary outcomes. Results: A total of 40 (13.9%) patients with NAS were identified, of which 35 patients were further treated in an EBSP. Furthermore, 16 (46%) patients terminated EBSP successfully, and nine (26%) patients died during the program. All deaths were caused by cholangitis. Of those, one (11%) patient had an extrahepatic stricture, while the other eight patients had either intrahepatic (3, 33%) or combined extra- and intrahepatic strictures (5, 56%). Risk factors of overall mortality were age (p = 0.03), bilirubin (p < 0.0001), alanine transaminase (p = 0.006), and aspartate transaminase (p = 0.0003). The median duration of the stent program was 34 months (ITBL: 36 months; IBL: 10 months), and procedural complications were rare. Conclusions: EBSP is safe, but lengthy and successful in only about half the patients. Intrahepatic strictures were associated with an increased risk of cholangitis.
- Subjects
CHOLANGITIS; LIVER transplantation; ALANINE aminotransferase; ASPARTATE aminotransferase; MORTALITY risk factors; ENDOSCOPIC retrograde cholangiopancreatography; CHOLANGIOGRAPHY
- Publication
Journal of Clinical Medicine, 2023, Vol 12, Issue 10, p3491
- ISSN
2077-0383
- Publication type
Article
- DOI
10.3390/jcm12103491