Outcomes of endoscopic retrograde cholangiography and percutaneous transhepatic biliary drainage in liver transplant recipients with a Roux-en-Y biliary-enteric anastomosis.
Biliary tract diseases
Endoscopy
Liver transplantation
Roux-en-Y anastomosis
Journal
Annals of hepato-biliary-pancreatic surgery
ISSN: 2508-5859
Titre abrégé: Ann Hepatobiliary Pancreat Surg
Pays: Korea (South)
ID NLM: 101698342
Informations de publication
Date de publication:
28 Feb 2023
28 Feb 2023
Historique:
received:
02
06
2022
revised:
25
07
2022
accepted:
01
08
2022
pubmed:
18
10
2022
medline:
18
10
2022
entrez:
17
10
2022
Statut:
ppublish
Résumé
Data regarding outcomes of endoscopic retrograde cholangiography (ERC) in liver transplant (LT) recipients with biliary-enteric (BE) anastomosis are limited. We report outcomes of ERC and percutaneous transhepatic biliary drainage (PTBD) as first-line therapies in LT recipients with BE anastomosis. All LT recipients with Roux-BE anastomosis from 2001 to 2020 were divided into ERC and PTBD subgroups. Technical success was defined as the ability to cannulate the bile duct. Clinical success was defined as the ability to perform cholangiography and therapeutic interventions. A total of 36 LT recipients (25 males, age 53.5 ± 13 years) with Roux-BE anastomosis who underwent biliary intervention were identified. The most common indications for a BE anastomosis were primary sclerosing cholangitis (n = 14) and duct size mismatch (n = 10). Among the 29 patients who initially underwent ERC, technical success and clinical success were achieved in 24 (82.8%) and 22 (75.9%) patients, respectively. The initial endoscope used for the ERC was a single balloon enteroscope in 16 patients, a double balloon enteroscope in 7 patients, a pediatric colonoscope in 5 patients, and a conventional reusable duodenoscope in 1 patient. Among the 7 patients who underwent PTBD as the initial therapy, six (85.7%) achieved technical and clinical success ( In LT patients with Roux-BE anastomosis requiring biliary intervention, ERC with a balloon-assisted enteroscope is safe with a success rate comparable to PTBD. Both ERC and PTBD can be considered as first-line therapies for LT recipients with a BE anastomosis.
Sections du résumé
Backgrounds/Aims
UNASSIGNED
Data regarding outcomes of endoscopic retrograde cholangiography (ERC) in liver transplant (LT) recipients with biliary-enteric (BE) anastomosis are limited. We report outcomes of ERC and percutaneous transhepatic biliary drainage (PTBD) as first-line therapies in LT recipients with BE anastomosis.
Methods
UNASSIGNED
All LT recipients with Roux-BE anastomosis from 2001 to 2020 were divided into ERC and PTBD subgroups. Technical success was defined as the ability to cannulate the bile duct. Clinical success was defined as the ability to perform cholangiography and therapeutic interventions.
Results
UNASSIGNED
A total of 36 LT recipients (25 males, age 53.5 ± 13 years) with Roux-BE anastomosis who underwent biliary intervention were identified. The most common indications for a BE anastomosis were primary sclerosing cholangitis (n = 14) and duct size mismatch (n = 10). Among the 29 patients who initially underwent ERC, technical success and clinical success were achieved in 24 (82.8%) and 22 (75.9%) patients, respectively. The initial endoscope used for the ERC was a single balloon enteroscope in 16 patients, a double balloon enteroscope in 7 patients, a pediatric colonoscope in 5 patients, and a conventional reusable duodenoscope in 1 patient. Among the 7 patients who underwent PTBD as the initial therapy, six (85.7%) achieved technical and clinical success (
Conclusions
UNASSIGNED
In LT patients with Roux-BE anastomosis requiring biliary intervention, ERC with a balloon-assisted enteroscope is safe with a success rate comparable to PTBD. Both ERC and PTBD can be considered as first-line therapies for LT recipients with a BE anastomosis.
Identifiants
pubmed: 36245257
pii: ahbps.22-037
doi: 10.14701/ahbps.22-037
pmc: PMC9947378
doi:
Types de publication
Journal Article
Langues
eng
Pagination
49-55Références
Dig Dis Sci. 2021 Jan;66(1):231-237
pubmed: 32124198
Dig Liver Dis. 2018 Nov;50(11):1220-1224
pubmed: 29907534
Gastroenterol Hepatol (N Y). 2010 Apr;6(4):264-72
pubmed: 20567581
Transplantation. 2004 Jan 15;77(1):110-5
pubmed: 14724444
HPB (Oxford). 2020 Jul;22(7):979-986
pubmed: 31676256
Br J Radiol. 2020 Apr;93(1108):20191046
pubmed: 31971831
Ann Transplant. 2011 Apr-Jun;16(2):5-13
pubmed: 21716179
Clin Transplant. 2008 Jul-Aug;22(4):484-93
pubmed: 18318735
Dig Surg. 2008;25(4):245-57
pubmed: 18628624
Dig Dis Sci. 2017 May;62(5):1327-1333
pubmed: 28265825
Transplantation. 2004 Feb 27;77(4):602-4
pubmed: 15084943
Hepatology. 2010 Feb;51(2):660-78
pubmed: 20101749
Gastrointest Endosc. 2015 Jan;81(1):81-9
pubmed: 25442089
Endosc Ultrasound. 2019 Nov 28;8(Suppl 1):S57-S66
pubmed: 31897381
Gastrointest Endosc. 2016 Jun;83(6):1061-75
pubmed: 27103361
Dig Dis Sci. 2019 Sep;64(9):2638-2644
pubmed: 31129875
Gastrointest Endosc. 2010 Mar;71(3):446-54
pubmed: 20189503
Ann Hepatobiliary Pancreat Surg. 2022 Feb 28;26(1):76-83
pubmed: 35013006
Transpl Int. 2011 Apr;24(4):379-92
pubmed: 21143651
Ann R Coll Surg Engl. 2017 Mar;99(3):210-215
pubmed: 27659373
Surg Endosc. 2008 Oct;22(10):2281-300
pubmed: 18791862
Liver Transpl Surg. 1995 May;1(3):143-52
pubmed: 9346556
J Am Coll Surg. 1994 Aug;179(2):177-81
pubmed: 8044387
J Gastroenterol Hepatol. 2021 Jul;36(7):2008-2014
pubmed: 33373488
Dig Dis Sci. 2019 Jul;64(7):2024-2030
pubmed: 30604376
Gastrointest Endosc. 2015 Apr;81(4):795-803
pubmed: 25665931
Gastrointest Endosc. 2013 Apr;77(4):568-77
pubmed: 23369652
Liver Transpl. 2007 Aug;13(8):1168-73
pubmed: 17663414
AJR Am J Roentgenol. 2012 Nov;199(5):1149-52
pubmed: 23096192