An Update on Endoscopic Management of Post-Liver Transplant Biliary Complications
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...
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| Format: | Article |
| Language: | English |
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Korean Society of Gastrointestinal Endoscopy
2017-09-01
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| Series: | Clinical Endoscopy |
| Subjects: | |
| Online Access: | http://www.e-ce.org/upload/pdf/ce-2016-139.pdf |
| _version_ | 1797427044622008320 |
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| author | Hyun Woo Lee Najmul Hassan Shah Sung Koo Lee |
| author_facet | Hyun Woo Lee Najmul Hassan Shah Sung Koo Lee |
| author_sort | Hyun Woo Lee |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-03-09T08:38:35Z |
| format | Article |
| id | doaj.art-2ae7aa92599f426da462c80b3b632969 |
| institution | Directory Open Access Journal |
| issn | 2234-2400 2234-2443 |
| language | English |
| last_indexed | 2024-03-09T08:38:35Z |
| publishDate | 2017-09-01 |
| publisher | Korean Society of Gastrointestinal Endoscopy |
| record_format | Article |
| series | Clinical Endoscopy |
| spelling | doaj.art-2ae7aa92599f426da462c80b3b6329692023-12-02T17:21:32ZengKorean Society of Gastrointestinal EndoscopyClinical Endoscopy2234-24002234-24432017-09-0150545146310.5946/ce.2016.1396978An Update on Endoscopic Management of Post-Liver Transplant Biliary ComplicationsHyun Woo Lee0Najmul Hassan Shah1Sung Koo Lee2 Division of Gastroenterology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea Division of Gastroenterology and Hepatology, Liver Transplant Program, Shifa International Hospital Ltd., Shifa College of Medicine, Islamabad, Pakistan Division of Gastroenterology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, KoreaBiliary 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.http://www.e-ce.org/upload/pdf/ce-2016-139.pdfLiver transplantationBiliary tract diseasesCholedocholithiasisAnastomotic leakCholangiopancreatography, endoscopic retrograde |
| spellingShingle | Hyun Woo Lee Najmul Hassan Shah Sung Koo Lee An Update on Endoscopic Management of Post-Liver Transplant Biliary Complications Clinical Endoscopy Liver transplantation Biliary tract diseases Choledocholithiasis Anastomotic leak Cholangiopancreatography, endoscopic retrograde |
| title | An Update on Endoscopic Management of Post-Liver Transplant Biliary Complications |
| title_full | An Update on Endoscopic Management of Post-Liver Transplant Biliary Complications |
| title_fullStr | An Update on Endoscopic Management of Post-Liver Transplant Biliary Complications |
| title_full_unstemmed | An Update on Endoscopic Management of Post-Liver Transplant Biliary Complications |
| title_short | An Update on Endoscopic Management of Post-Liver Transplant Biliary Complications |
| title_sort | update on endoscopic management of post liver transplant biliary complications |
| topic | Liver transplantation Biliary tract diseases Choledocholithiasis Anastomotic leak Cholangiopancreatography, endoscopic retrograde |
| url | http://www.e-ce.org/upload/pdf/ce-2016-139.pdf |
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