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Anastomotic stricture after liver transplantation: It is not Achilles’ heel anymore!

Authors
 Sung Ill Jang  ;  Dong Ki Lee 
Citation
 Gastrointestinal Intervention, Vol.7(2) : 57-66, 2018 
Journal Title
 Gastrointestinal Intervention 
ISSN
 2213-1795 
Issue Date
2018
Keywords
Anastomosis ; Bile duct obstruction ; Complication ; Liver transplantation ; Stricture
Abstract
Biliary-tract complications, such as biliary strictures, anastomotic leaks, choledocholithiasis, and biliary casts, can occur after liver transplantation (LT). Of these complications, biliary strictures are regarded as an Achilles’ heel. Recently, treatment of anastomotic biliary stricture (ABS) has transitioned from conventional surgical revision to a nonsurgical treatment modality. Endoscopic serial balloon dilatation and/or multiple plastic stent replacements are highly effective and are now regarded as the first-line treatments. However, if the patient has undergone anastomosis by means of a hepaticojejunostomy, percutaneous treatment is performed. With recent technological advances and the rendezvous method, the clinical success rates of endoscopic and percutaneous ABS treatments have increased, but these methods fail in some patients who have total obstruction of anastomotic stricture. For these patients, magnetic compression anastomosis (MCA) has been suggested as an alternative method. Animal and human studies have demonstrated the safety and efficacy of MCA, and advancements in these nonsurgical methods have increased the clinical success rate of ABS. This review focuses on ABSs that develop after LT and discusses the clinical results of various nonsurgical methods and future directions.
Full Text
http://www.gi-intervention.org/journal/view.html?uid=173&vmd=Full&
DOI
10.18528/gii180012
Appears in Collections:
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실)
Yonsei Authors
이동기(Lee, Dong Ki) ORCID logo https://orcid.org/0000-0002-0048-9112
장성일(Jang, Sung Ill) ORCID logo https://orcid.org/0000-0003-4937-6167
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/163216
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