Safety and effectiveness of endoscopic treatment for biliary tract complications after liver transplantation_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

XIAO Lina , LI Xiao , GENG Chong ,  WANG Chunhui

Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;

Corresponding author：

WANG Chunhui, Email: wangch@scu.edu.cn

Keywords：

endoscopic treatment; biliary tract complication; liver transplantation

DOI：

10.7507/1007-9424.201909051

Video：

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Objective To explore the safety and effectiveness of endoscopic treatment for biliary tract complications after liver transplantation.Methods Patients who underwent endoscopic treatment for biliary tract complications after liver transplantation from January 2009 to December 2018 in West China Hospital were enrolled. Characteristics of patients, types of biliary tract complications, effectiveness of endoscopic treatment and endoscopic related complications were collected and analyzed.Results Among the 57 patients with biliary tract complications, 37 patients had biliary stricture alone, 4 patients had bile leak alone, 15 patients had biliary stricture plus biliary stones or sludge, and 1 patient had biliary stricture combined with biliary leakage. A total of 112 treatments of endoscopic retrograde cholangiopancreatography (ERCP) were performed, among which 100 treatments were accomplished successfully (89.3%), including the improvement of bile duct stenosis, the cure of bile leak and the successful removal of common bile duct stones. The number of total ERCP related complications was 15 (13.4%), among which post ERCP pancreatitis was the most common (9.8%).Conclusion Endoscopic therapy can be considered as an initial treatment for biliary tract complications after liver transplantation as its safety and effectiveness.

Citation： XIAO Lina, LI Xiao, GENG Chong, WANG Chunhui. Safety and effectiveness of endoscopic treatment for biliary tract complications after liver transplantation. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2020, 27(1): 53-57. doi: 10.7507/1007-9424.201909051 Copy

1.	Jadlowiec CC, Taner T. Liver transplantation: Current status and challenges. World J Gastroenterol, 2016, 22(18): 4438-4445.
2.	Bittencourt PL, Farias AQ, Couto CA. Liver transplantation in Brazil. Liver Transpl, 2016, 22(9): 1254-1258.
3.	Balderramo D, Navasa M, Cardenas A. Current management of biliary complications after liver transplantation: emphasis on endoscopic therapy. Gastroenterol Hepatol, 2011, 34(2): 107-115.
4.	Brown RS Jr, Russo MW, Lai M, et al. A survey of liver transplantation from living adult donors in the United States. N Engl J Med, 2003, 348(9): 818-825.
5.	Kochhar G, Parungao JM, Hanouneh IA, et al. Biliary complications following liver transplantation. World J Gastroenterol, 2013, 19(19): 2841-2846.
6.	Wojcicki M, Milkiewicz P, Silva M. Biliary tract complications after liver transplantation: a review. Dig Surg, 2008, 25(4): 245-257.
7.	Tarantino I, Barresi L, Petridis I, et al. Endoscopic treatment of biliary complications after liver transplantation. World J Gastroenterol, 2008, 14(26): 4185-4189.
8.	Arain MA, Attam R, Freeman ML. Advances in endoscopic management of biliary tract complications after liver transplantation. Liver Transpl, 2013, 19(5): 482-498.
9.	Roos FJM, Poley JW, Polak WG, et al. Biliary complications after liver transplantation; recent developments in etiology, diagnosis and endoscopic treatment. Best Pract Res Clin Gastroenterol, 2017, 31(2): 227-235.
10.	王征, 周俭. 中国肝癌肝移植现状及展望. 实用器官移植电子杂志, 2019, 7(1): 1-3.
11.	Sossenheimer M, Slivka A, Carr-Locke D. Management of extrahepatic biliary disease after orthotopic liver transplantation: review of the literature and results of a multicenter survey. Endoscopy, 1996, 28(7): 565-571.
12.	Fernandez-Simon A, Diaz-Gonzalez A, Thuluvath PJ, et al. Endoscopic retrograde cholangiography for biliary anastomotic strictures after liver transplantation. Clin Liver Dis, 2014, 18(4): 913-926.
13.	Shin M, Joh JW. Advances in endoscopic management of biliary complications after living donor liver transplantation: Comprehensive review of the literature. World J Gastroenterol, 2016, 22(27): 6173-6191.
14.	Rao HB, Ahamed H, Panicker S, et al. Endoscopic therapy for biliary strictures complicating living donor liver transplantation: Factors predicting better outcome. World J Gastrointest Pathophysiol, 2017, 8(2): 77-86.
15.	Rao HB, Prakash A, Sudhindran S, et al. Biliary strictures complicating living donor liver transplantation: Problems, novel insights and solutions. World J Gastroenterol, 2018, 24(19): 2061-2072.
16.	Moy BT, Birk JW. A review on the management of biliary complications after orthotopic liver transplantation. J Clin Transl Hepatol, 2019, 7(1): 61-71.
17.	Sharma S, Gurakar A, Jabbour N. Biliary strictures following liver transplantation: past, present and preventive strategies. Liver Transpl, 2008, 14(6): 759-769.
18.	Zoepf T, Maldonado-Lopez EJ, Hilgard P, et al. Balloon dilatation vs. balloon dilatation plus bile duct endoprostheses for treatment of anastomotic biliary strictures after liver transplantation. Liver Transpl, 2006, 12(1): 88-94.
19.	Krok KL, Cardenas A, Thuluvath PJ. Endoscopic management of biliary complications after liver transplantation. Clin Liver Dis, 2010, 14(2): 359-371.
20.	Crismale JF, Ahmad J. Endoscopic management of biliary issues in the liver transplant patient. Gastrointest Endosc Clin N Am, 2019, 29(2): 237-256.
21.	Macias-Gomez C, Dumonceau JM. Endoscopic management of biliary complications after liver transplantation: An evidence-based review. World J Gastroenterol, 2015, 7(6): 606-616.
22.	Eminler AT, Parlak E, Koksal AS, et al. Endoscopic treatment of biliary stones in patients with liver transplantation. Surg Endosc, 2017, 31(3): 1327-1335.
23.	Pfau PR, Kochman ML, Lewis JD, et al. Endoscopic management of postoperative biliary complications in orthotopic liver transplantation. Gastrointest Endosc, 2000, 52(1): 55-63.
24.	Rerknimitr R, Sherman S, Fogel EL, et al. Biliary tract complications after orthotopic liver transplantation with choledochocholedochostomy anastomosis: endoscopic findings and results of therapy. Gastrointest Endosc, 2002, 55(2): 224-231.
25.	Spier BJ, Pfau PR, Lorenze KR, et al. Risk factors and outcomes in post-liver transplantation bile duct stones and casts: A case-control study. Liver Transpl, 2008, 14(10): 1461-1465.
26.	Scanga AE, Kowdley KV. Management of biliary complications following orthotopic liver transplantation. Curr Gastroenterol Rep, 2007, 9(1): 31-38.
27.	Thuluvath PJ, Pfau PR, Kimmey MB, et al. Biliary complications after liver transplantation: the role of endoscopy. Endoscopy, 2005, 37(9): 857-863.
28.	Lee HW, Shah NH, Lee SK. An update on endoscopic management of post-liver transplant biliary complications. Clin Endosc, 2017, 50(5): 451-463.
29.	Elmunzer BJ. Reducing the risk of post-endoscopic retrograde cholangiopancreatography pancreatitis. Dig Endosc, 2017, 29(7): 749-757.
30.	Kim NH, Kim HJ, Bang KB. Prospective comparison of prophylactic antibiotic use between intravenous moxifloxacin and ceftriaxone for high-risk patients with post-ERCP cholangitis. Hepatobiliary Pancreat Dis Int, 2017, 16(5): 512-518.
31.	Chen M, Wang L, Wang Y, et al. Risk factor analysis of post-ERCP cholangitis: A single-center experience. Hepatobiliary Pancreat Dis Int, 2018, 17(1): 55-58.

1. Jadlowiec CC, Taner T. Liver transplantation: Current status and challenges. World J Gastroenterol, 2016, 22(18): 4438-4445.
2. Bittencourt PL, Farias AQ, Couto CA. Liver transplantation in Brazil. Liver Transpl, 2016, 22(9): 1254-1258.
3. Balderramo D, Navasa M, Cardenas A. Current management of biliary complications after liver transplantation: emphasis on endoscopic therapy. Gastroenterol Hepatol, 2011, 34(2): 107-115.
4. Brown RS Jr, Russo MW, Lai M, et al. A survey of liver transplantation from living adult donors in the United States. N Engl J Med, 2003, 348(9): 818-825.
5. Kochhar G, Parungao JM, Hanouneh IA, et al. Biliary complications following liver transplantation. World J Gastroenterol, 2013, 19(19): 2841-2846.
6. Wojcicki M, Milkiewicz P, Silva M. Biliary tract complications after liver transplantation: a review. Dig Surg, 2008, 25(4): 245-257.
7. Tarantino I, Barresi L, Petridis I, et al. Endoscopic treatment of biliary complications after liver transplantation. World J Gastroenterol, 2008, 14(26): 4185-4189.
8. Arain MA, Attam R, Freeman ML. Advances in endoscopic management of biliary tract complications after liver transplantation. Liver Transpl, 2013, 19(5): 482-498.
9. Roos FJM, Poley JW, Polak WG, et al. Biliary complications after liver transplantation; recent developments in etiology, diagnosis and endoscopic treatment. Best Pract Res Clin Gastroenterol, 2017, 31(2): 227-235.
10. 王征, 周俭. 中国肝癌肝移植现状及展望. 实用器官移植电子杂志, 2019, 7(1): 1-3.
11. Sossenheimer M, Slivka A, Carr-Locke D. Management of extrahepatic biliary disease after orthotopic liver transplantation: review of the literature and results of a multicenter survey. Endoscopy, 1996, 28(7): 565-571.
12. Fernandez-Simon A, Diaz-Gonzalez A, Thuluvath PJ, et al. Endoscopic retrograde cholangiography for biliary anastomotic strictures after liver transplantation. Clin Liver Dis, 2014, 18(4): 913-926.
13. Shin M, Joh JW. Advances in endoscopic management of biliary complications after living donor liver transplantation: Comprehensive review of the literature. World J Gastroenterol, 2016, 22(27): 6173-6191.
14. Rao HB, Ahamed H, Panicker S, et al. Endoscopic therapy for biliary strictures complicating living donor liver transplantation: Factors predicting better outcome. World J Gastrointest Pathophysiol, 2017, 8(2): 77-86.
15. Rao HB, Prakash A, Sudhindran S, et al. Biliary strictures complicating living donor liver transplantation: Problems, novel insights and solutions. World J Gastroenterol, 2018, 24(19): 2061-2072.
16. Moy BT, Birk JW. A review on the management of biliary complications after orthotopic liver transplantation. J Clin Transl Hepatol, 2019, 7(1): 61-71.
17. Sharma S, Gurakar A, Jabbour N. Biliary strictures following liver transplantation: past, present and preventive strategies. Liver Transpl, 2008, 14(6): 759-769.
18. Zoepf T, Maldonado-Lopez EJ, Hilgard P, et al. Balloon dilatation vs. balloon dilatation plus bile duct endoprostheses for treatment of anastomotic biliary strictures after liver transplantation. Liver Transpl, 2006, 12(1): 88-94.
19. Krok KL, Cardenas A, Thuluvath PJ. Endoscopic management of biliary complications after liver transplantation. Clin Liver Dis, 2010, 14(2): 359-371.
20. Crismale JF, Ahmad J. Endoscopic management of biliary issues in the liver transplant patient. Gastrointest Endosc Clin N Am, 2019, 29(2): 237-256.
21. Macias-Gomez C, Dumonceau JM. Endoscopic management of biliary complications after liver transplantation: An evidence-based review. World J Gastroenterol, 2015, 7(6): 606-616.
22. Eminler AT, Parlak E, Koksal AS, et al. Endoscopic treatment of biliary stones in patients with liver transplantation. Surg Endosc, 2017, 31(3): 1327-1335.
23. Pfau PR, Kochman ML, Lewis JD, et al. Endoscopic management of postoperative biliary complications in orthotopic liver transplantation. Gastrointest Endosc, 2000, 52(1): 55-63.
24. Rerknimitr R, Sherman S, Fogel EL, et al. Biliary tract complications after orthotopic liver transplantation with choledochocholedochostomy anastomosis: endoscopic findings and results of therapy. Gastrointest Endosc, 2002, 55(2): 224-231.
25. Spier BJ, Pfau PR, Lorenze KR, et al. Risk factors and outcomes in post-liver transplantation bile duct stones and casts: A case-control study. Liver Transpl, 2008, 14(10): 1461-1465.
26. Scanga AE, Kowdley KV. Management of biliary complications following orthotopic liver transplantation. Curr Gastroenterol Rep, 2007, 9(1): 31-38.
27. Thuluvath PJ, Pfau PR, Kimmey MB, et al. Biliary complications after liver transplantation: the role of endoscopy. Endoscopy, 2005, 37(9): 857-863.
28. Lee HW, Shah NH, Lee SK. An update on endoscopic management of post-liver transplant biliary complications. Clin Endosc, 2017, 50(5): 451-463.
29. Elmunzer BJ. Reducing the risk of post-endoscopic retrograde cholangiopancreatography pancreatitis. Dig Endosc, 2017, 29(7): 749-757.
30. Kim NH, Kim HJ, Bang KB. Prospective comparison of prophylactic antibiotic use between intravenous moxifloxacin and ceftriaxone for high-risk patients with post-ERCP cholangitis. Hepatobiliary Pancreat Dis Int, 2017, 16(5): 512-518.
31. Chen M, Wang L, Wang Y, et al. Risk factor analysis of post-ERCP cholangitis: A single-center experience. Hepatobiliary Pancreat Dis Int, 2018, 17(1): 55-58.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Safety and effectiveness of endoscopic treatment for biliary tract complications after liver transplantation

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