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Original Article
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Ex vivo cholangioscopy in liver grafts: a novel technique to assess the biliary tree during organ preservation and machine perfusion: a experimental non-clinical study
- Mark Ly, Ngee-Soon Lau, Joanna Huang, Hayden Ly, Kasper Ewenson, Nicole Mestrovic, Paul Yousif, Ken Liu, Avik Majumdar, Geoffrey McCaughan, Michael Crawford, Carlo Pulitano
- Clin Endosc 2025;58(2):303-310. Published online March 4, 2025
- DOI: https://doi.org/10.5946/ce.2024.099
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Graphical Abstract
Abstract
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ePub - Background
/Aims: Biliary complications are a leading cause of morbidity after liver transplantation, but can be reduced using real-time assessment of the biliary tree. This study described a novel technique for performing ex vivo cholangioscopy during cold static storage and normothermic machine perfusion (NMP) to assess the biliary tree before liver transplantation.
Methods
Human donor livers, which were considered unsuitable for transplantation, were perfused at 36ºC using a modified commercial ex vivo perfusion system. Ex vivo cholangioscopy was performed using a SpyGlass Discover system. Cholangioscopy was performed during cold static storage and after 12 hours in NMP. Bile duct biopsies and confocal microscopy were performed.
Results
Ex vivo cholangioscopy was performed on eight grafts. During cold static storage, luminal debris was visualized throughout the biliary tree. After 12 hours of reperfusion, the bile ducts appeared hyperemic, heterogeneous, and mottled. Confocal microscopy confirmed perfusion of biliary microvasculature.
Conclusions
We describe the first use of ex vivo cholangioscopy to assess the biliary tree before liver transplantation. This real-time technique can be used to assess biliary trees during cold static storage and NMP. In addition, cholangioscopy-based interventions can be used to better assess intrahepatic bile ducts.
- 760 View
- 109 Download
Focused Review Series: Endoscopic Management for Biliary Stricture after Liver Transplantations
- Management of Post-Transplant Anastomotic Stricture Using Self-Expandable Metal Stent
- Dong Wook Lee, Kazuo Hara
- Clin Endosc 2020;53(3):261-265. Published online May 29, 2020
- DOI: https://doi.org/10.5946/ce.2020.119
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Abstract
PDFPubReaderePub
- Anastomotic stricture (AS) is one of the complications of liver transplantation (LT) and can occur in up to 40% of living-donor LTs. Endoscopic management has become the first-line treatment of AS, and multiple plastic stents insertion has been mainly used in the past. Recently, many treatments utilizing fully covered self-expandable metal stents (cSEMSs) have been attempted, and results showing adequate treatment outcome have been reported. In this review, we look into the treatment performance and cautionary steps needed when using cSEMS as a treatment for AS.
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Citations
Citations to this article as recorded by
- Management of biliary complications in liver transplant recipients using a fully covered self-expandable metal stent with antimigration features
Andrew CANAKIS, Andrew J. GILMAN, Todd H. BARON
Minerva Gastroenterology.2024;[Epub] CrossRef - Endoscopic Management of Biliary Strictures after Orthotopic Liver Transplantation: A Single Center Experience Study
Vasile Sandru, Madalina Stan-Ilie, Oana-Mihaela Plotogea, Catalina Vladut, Bogdan Silviu Ungureanu, Gheorghe G. Balan, Dan Ionut Gheonea, Gabriel Constantinescu
Diagnostics.2022; 12(5): 1221. CrossRef - Efficacy of a modified short fully covered self‐expandable metal stent for perihilar benign biliary strictures
Tae Hoon Lee, Jong Ho Moon, Yun Nah Lee, Seok Jung Jo, Jae Keun Park, Jae Kook Yang, Sang‐Woo Cha, Young Deok Cho, Sang‐Heum Park
Journal of Gastroenterology and Hepatology.2021; 36(4): 1057. CrossRef
- Management of biliary complications in liver transplant recipients using a fully covered self-expandable metal stent with antimigration features
- 5,787 View
- 158 Download
- 3 Web of Science
- 3 Crossref
- Unilateral Versus Bilateral Biliary Drainage for Post-Transplant Anastomotic Stricture
- Jin Ho Choi, Woo Hyun Paik
- Clin Endosc 2020;53(3):255-260. Published online May 22, 2020
- DOI: https://doi.org/10.5946/ce.2020.079
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Abstract
PDFPubReaderePub
- Living donor liver transplantation is the most common type of liver transplantation in Asia. Post-transplant biliary stricture is frequent in living donor liver transplantation, and endoscopic management is considered to be the treatment of choice. However, endoscopic management is still challenging in patients who undergo right lobe living donor liver transplantation because of the anatomical alteration. In this article, we reviewed the recently updated results for proper endoscopic biliary drainage in post-living donor liver transplantation anatomical biliary stricture and compared unilateral and bilateral drainage.
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Citations
Citations to this article as recorded by- Digital single-operator cholangioscopy for difficult anastomotic biliary strictures in living donor liver transplant recipients after failure of standard ERCP: SPYPASS-2 study (with videos)
In Rae Cho, Sang Hyub Lee, Joongyu Kang, Junyeol Kim, Tae Seung Lee, Myeong Hwan Lee, Min Woo Lee, Jin Ho Choi, Woo Hyun Paik, Ji Kon Ryu, Yong-Tae Kim, Suk Kyun Hong, YoungRok Choi, Nam-Joon Yi, Kwang-Woong Lee, Kyung-Suk Suh
Gastrointestinal Endoscopy.2025; 101(5): 979. CrossRef - Development of novel biliary metal stent with coil-spring structure and its application in vivo swine biliary stricture model
In Rae Cho, Sang Hyub Lee, Jin Ho Choi, Namyoung Park, Min Woo Lee, Joo Seong Kim, Seok Jeong, Don Haeng Lee, Tae-Won Jeong, Byoung-Yun Ki, Woo Hyun Paik, Ji Kon Ryu, Yong-Tae Kim
Frontiers in Oncology.2023;[Epub] CrossRef
- Digital single-operator cholangioscopy for difficult anastomotic biliary strictures in living donor liver transplant recipients after failure of standard ERCP: SPYPASS-2 study (with videos)
- 5,659 View
- 125 Download
- 2 Web of Science
- 2 Crossref
Reviews
- An Update on Endoscopic Management of Post-Liver Transplant Biliary Complications
- Hyun Woo Lee, Najmul Hassan Shah, Sung Koo Lee
- Clin Endosc 2017;50(5):451-463. Published online April 17, 2017
- DOI: https://doi.org/10.5946/ce.2016.139
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Abstract
PDFPubReaderePub
- 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 (LDLT) compared to a deceased-donor LT (DDLT). 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 (ERCP) remains the preferred initial treatment. However, percutaneous transhepatic cholangioscopy (PTCS) 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 (MCA), and peroral cholangioscopy (POCS)—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.
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Citations
Citations to this article as recorded by- Biliary Leak Healing in Liver Transplants: What Makes a Difference?
D Gambaccini, D Stefani Donati, A Venturini, G Tapete, V Natali, V Bolognesi, P Visaggi, A Pancetti, F Ovidi, I Solinas, A Grosso, M Bellini, E Marciano
Endoscopy.2025; 57(S 02): S385. CrossRef - Asian Pacific Association for the Study of the Liver clinical practice guidelines on liver transplantation
Dong-Sik Kim, Young-In Yoon, Beom Kyung Kim, Ashok Choudhury, Anand Kulkarni, Jun Yong Park, Jongman Kim, Dong Hyun Sinn, Dong Jin Joo, YoungRok Choi, Jeong-Hoon Lee, Ho Joong Choi, Ki Tae Yoon, Sun Young Yim, Cheon-Soo Park, Deok-Gie Kim, Hae Won Lee, Wo
Hepatology International.2024; 18(2): 299. CrossRef - Surgical and Interventional Radiology Management of Vascular and Biliary Complications in Liver Transplantation: Narrative Review
Camilo Barragan, Alonso Vera, Sergio Hoyos, Diana Bejarano, Ana Maria Lopez-Ruiz, Francisco Grippi, Alejandro Mejia, María del Pilar Bayona Molano
Digestive Disease Interventions.2024; 08(01): 7. CrossRef - Management of biliary complications in liver transplant recipients using a fully covered self-expandable metal stent with antimigration features
Andrew CANAKIS, Andrew J. GILMAN, Todd H. BARON
Minerva Gastroenterology.2024;[Epub] CrossRef - S2k-Leitlinie Lebertransplantation der Deutschen Gesellschaft für Gastroenterologie, Verdauungs- und Stoffwechselkrankheiten (DGVS) und der Deutschen Gesellschaft für Allgemein- und Viszeralchirurgie (DGAV)
Thomas Berg, Niklas F. Aehling, Tony Bruns, Martin-Walter Welker, Tobias Weismüller, Jonel Trebicka, Frank Tacke, Pavel Strnad, Martina Sterneck, Utz Settmacher, Daniel Seehofer, Eckart Schott, Andreas Anton Schnitzbauer, Hartmut H. Schmidt, Hans J. Schli
Zeitschrift für Gastroenterologie.2024; 62(09): 1397. CrossRef - Evaluating the yield of digital single operator cholangioscopy in posttransplant biliary strictures after unsuccessful guidewire placement with ERCP
Jonathan Ng, Sujievvan Chandran, Kim Hay Be, Leonardo Zorron Cheng Tao Pu, Kevin Kyung Ho Choi, Payal Saxena, Arthur John Kaffes, Rhys Vaughan, Marios Efthymiou
JGH Open.2024;[Epub] CrossRef - Does T-tube indwelling prolong the procedure of endoscopic retrograde cholangiopancreatography for healing duct-to-duct anastomotic bile leakage after liver transplantation?
Songming Ding, Shanjie Dong, Hengkai Zhu, Shusen Zheng, Qiyong Li
Medicine.2024; 103(43): e40191. CrossRef - Percutaneous transhepatic biliary drainage in patients with cholestasis following liver transplantation
Thorben Pape, Tabea von Garrel, Anna M. Hunkemöller, Bahar Nalbant, Florian W. R. Vondran, Nicolas Richter, Benjamin Heidrich, Andrea Schneider, Richard Taubert, Thomas von Hahn, Heiner Wedemeyer, Benjamin Seeliger, Henrike Lenzen, Klaus Stahl
Abdominal Radiology.2024; 50(4): 1699. CrossRef - Emerging strategies in outpatient endoscopy sedation management: Recent trends and developments
Ming-Qi Chen, Qi-Sheng Zhang
World Journal of Gastrointestinal Endoscopy.2024; 16(12): 686. CrossRef - Anatomical classification and clinical outcomes of biliary strictures in living donor liver transplantation using right liver grafts
Hansang Park, Eui Soo Han, Sae‐Jin Park, Su Young Hong, Sanggyun Suh, Sola Lee, Jeong‐Moo Lee, Suk Kyun Hong, YoungRok Choi, Kwang‐Woong Lee, Kyung‐Suk Suh, Nam‐Joon Yi, Joon Koo Han
Liver Transplantation.2023; 29(3): 307. CrossRef - Do We Need to Use a Stent in Biliary Reconstruction to Decrease the Incidence of Biliary Complications in Liver Transplantation? A Systematic Review and Meta-Analysis
Beshoy Effat Elkomos, Amr Abdelaal
Journal of Gastrointestinal Surgery.2023; 27(1): 180. CrossRef - Biliary and Vascular Complications after Liver Transplantation–From Diagnosis to Treatment
Gina Gheorghe, Camelia Diaconu, Simona Bungau, Nicolae Bacalbasa, Natalia Motas, Vlad-Alexandru Ionescu
Medicina.2023; 59(5): 850. CrossRef - Immediate and Late Complications After Liver Transplantation
Christopher Buros, Atman Ashwin Dave, Alessandro Furlan
Radiologic Clinics of North America.2023; 61(5): 785. CrossRef - Antimigration versus conventional fully covered metal stents in the endoscopic treatment of anastomotic biliary strictures after deceased-donor liver transplantation
Esteban Fuentes-Valenzuela, Marina de Benito Sanz, Félix García-Pajares, José Estradas, Irene Peñas-Herrero, Miguel Durá-Gil, Ana Yaiza Carbajo, Carlos de la Serna-Higuera, Ramon Sanchez-Ocana, Carmen Alonso-Martín, Carolina Almohalla, Gloria Sánchez-Anto
Surgical Endoscopy.2023; 37(9): 6975. CrossRef - Endoscopic and Percutaneous Biliary Interventions after Liver Transplantation: Nationwide Data in Korea
Seung Bae Yoon, Jungmee Kim, Chang Nyol Paik, Dong Kee Jang, Jun Kyu Lee, Won Jae Yoon, Jung-Wook Kim, Tae Hee Lee, Jae-Young Jang
Gut and Liver.2022; 16(2): 300. CrossRef - “When two scopes meet”—Use of double cholangioscopy allows for a controlled perforation of an occluded postliver transplantation anastomotic stricture
Jonathan Ng, Leonardo Zorron Cheng Tao Pu, Kim Hay Be, Rhys Vaughan, Marios Efthymiou, Sujievvan Chandran
Liver Transplantation.2022; 28(7): 1254. CrossRef - Endoscopic Management of Biliary Strictures after Orthotopic Liver Transplantation: A Single Center Experience Study
Vasile Sandru, Madalina Stan-Ilie, Oana-Mihaela Plotogea, Catalina Vladut, Bogdan Silviu Ungureanu, Gheorghe G. Balan, Dan Ionut Gheonea, Gabriel Constantinescu
Diagnostics.2022; 12(5): 1221. CrossRef - Post-transplant biliary complications: advances in pathophysiology, diagnosis, and treatment
Matthew Fasullo, Milan Patel, Lauren Khanna, Tilak Shah
BMJ Open Gastroenterology.2022; 9(1): e000778. CrossRef - Incidence of Ischemia Reperfusion Injury Related Biliary Complications in Liver Transplantation: Effect of Different Types of Donors
Yafei Guo, Jizhou Wang, Wei Wu, Dehao Huang, Hao Zheng, Zhijun Xu, Xuefeng Li, Ning Wang, Jiwei Qin, Zebin Zhu, Yang Liu, Ziqin Yao, Haibo Wang, Qiang Huang, Lianxin Liu, Björn Nashan
Transplantation Proceedings.2022; 54(7): 1865. CrossRef - Risk factors and management of biliary stones after living donor liver transplant and its effect on graft outcome
Hany Dabbous, Ashraf Elsayed, Manar Salah, Iman Montasser, Mohamed Atef, Mahmoud Elmetenini
Frontiers in Medicine.2022;[Epub] CrossRef - Intensive care management of liver transplant recipients
Jody C. Olson, Ram Subramanian, Constantine J. Karvellas
Current Opinion in Critical Care.2022; 28(6): 709. CrossRef - Interventional Radiology Management of Adult Liver Transplant Complications
Sailendra G. Naidu, Sadeer J. Alzubaidi, Indravadan J. Patel, Chris Iwuchukwu, Kenneth S. Zurcher, Dania G. Malik, Martha-Gracia Knuttinen, J. Scott Kriegshauser, Alex L. Wallace, Nitin N. Katariya, Amit K. Mathur, Rahmi Oklu
RadioGraphics.2022; 42(6): 1705. CrossRef - Are short‐term complications associated with poor allograft and patient survival after liver transplantation? A systematic review of the literature and expert panel recommendations
Felipe Alconchel, Pascale Tinguely, Carlo Frola, Michael Spiro, Ruben Ciria, Gonzalo Rodríguez, Henrik Petrowsky, Dimitri Aristotle Raptis, Elizabeth W. Brombosz, Mark Ghobrial
Clinical Transplantation.2022;[Epub] CrossRef - Post-liver transplant biliary complications: Current knowledge and therapeutic advances
Irina Boeva, Petko Ivanov Karagyozov, Ivan Tishkov
World Journal of Hepatology.2021; 13(1): 66. CrossRef - Recurrent Primary Sclerosing Cholangitis: Current Understanding, Management, and Future Directions
Kristel K. Leung, Maya Deeb, Sandra E. Fischer, Aliya Gulamhusein
Seminars in Liver Disease.2021; 41(03): 409. CrossRef - Biliary Complications Following Adult Deceased Donor Liver Transplantation: Risk Factors and Implications at a High-volume US Center
Abraham J. Matar, Katie Ross-Driscoll, Lisa Kenney, Hannah K. Wichmann, Joseph F. Magliocca, William H. Kitchens
Transplantation Direct.2021; 7(10): e754. CrossRef - Endoscopic management of difficult common bile duct stones: Where are we now? A comprehensive review
Alberto Tringali, Deborah Costa, Alessandro Fugazza, Matteo Colombo, Kareem Khalaf, Alessandro Repici, Andrea Anderloni
World Journal of Gastroenterology.2021; 27(44): 7597. CrossRef - Graft Dysfunction and Management in Liver Transplantation
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Critical Care Clinics.2019; 35(1): 117. CrossRef - A Review on the Management of Biliary Complications after Orthotopic Liver Transplantation
Brian T. Moy, John W. Birk
Journal of Clinical and Translational Hepatology.2019; 7(1): 1. CrossRef - Endoscopic management of anastomotic stricture after living-donor liver transplantation
Dong Wook Lee, Jimin Han
The Korean Journal of Internal Medicine.2019; 34(2): 261. CrossRef - Endoscopic retrograde cholangiography and percutaneous transhepatic cholangiodrainage in biliary strictures after liver transplantation: Long‐term outcome predictors and influence on patient survival
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Liver International.2019; 39(6): 1155. CrossRef - Endoscopic management of biliary strictures post-liver transplantation
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World Journal of Meta-Analysis.2019; 7(4): 120. CrossRef - Large-duct cholangiopathies: aetiology, diagnosis and treatment
Shyam Menon, Andrew Holt
Frontline Gastroenterology.2019; 10(3): 284. CrossRef - Endoscopic treatment of biliary complications after duct-to-duct biliary anastomosis in pediatric liver transplantation
M. Harputluoglu, U. Demirel, A. R. Caliskan, A. Selimoglu, Y. Bilgic, M. Aladag, M. A. Erdogan, R. Dertli, Y. Atayan, S. Yilmaz
Langenbeck's Archives of Surgery.2019; 404(7): 875. CrossRef - Cholangioscopy-guided steroid injection for refractory post liver transplant anastomotic strictures: a rescue case series
Tomazo Franzini, Vitor M.T. Sagae, Hugo G. Guedes, Paulo Sakai, Daniel R. Waisberg, Wellington Andraus, Luiz A.C. D’Albuquerque, Amrita Sethi, Eduardo G.H. de Moura
Therapeutic Advances in Gastrointestinal Endoscopy.2019;[Epub] CrossRef
- Biliary Leak Healing in Liver Transplants: What Makes a Difference?
- 12,293 View
- 425 Download
- 36 Web of Science
- 35 Crossref
- Endoscopic Management of Anastomotic Strictures after Liver Transplantation
- Dong Wook Lee, Hyeong Ho Jo, Juveria Abdullah, Michel Kahaleh
- Clin Endosc 2016;49(5):457-461. Published online September 30, 2016
- DOI: https://doi.org/10.5946/ce.2016.130
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Abstract
PDFPubReaderePub
- Endoscopic treatment of biliary strictures involving plastic stent placement has been used widely. The use of self-expandable metal stents (SEMSs) has been described for anastomotic strictures following liver transplantation (LT). This review aimed to assess and compare the efficacy of plastic stents with SEMS in LT patients. Information was retrieved regarding technical success, stricture resolution, the number of endoscopic retrograde cholangiography procedures, follow-up, immediate, and late complications. Eight studies involving plastic stents had a stricture resolution rate of 84.5%, with the rates ranging from 63% to 100%. These rates are comparable with the stricture resolution rate of 75% determined from six studies that involved 236 patients who received metal stents and the rates ranged from 53% to 81%. The observed success rate for metal stents used to manage post-LT anastomotic biliary strictures was below the reported rate for multiple plastic stents. Hence, the currently available metal stents should not be offered for the management of post-LT anastomotic biliary strictures.
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Citations
Citations to this article as recorded by- Less is more: The use of single biodegradable stenting to treat biliary anastomotic strictures in pediatric liver transplantation
Jesús Quintero Bernabeu, Javier Juamperez Goñi, Maria Mercadal Hally, Cristina Padrós Fornieles, Mauricio Larrarte King, José Andrés Molino Gahete, Anna Coma Muñoz, Iratxe Diez Miranda, Mercedes Pérez Lafuente, Ramon Charco Torra, Ernest Hidalgo Llompart
Liver Transplantation.2024;[Epub] CrossRef - Long-Term Results of Endoscopic Metal Stenting for Biliary Anastomotic Stricture after Liver Transplantation
Aymeric Becq, Alexis Laurent, Quentin De Roux, Cristiano Cremone, Hugo Rotkopf, Yann Le Baleur, Farida Mesli, Christophe Duvoux, Aurélien Amiot, Charlotte Gagniere, Nicolas Mongardon, Julien Calderaro, Daniele Sommacale, Alain Luciani, Iradj Sobhani
Journal of Clinical Medicine.2023; 12(4): 1453. CrossRef - Endoskopisches Management von Gallengangskomplikationen nach Leberchirurgie
Martha M. Kirstein, Torsten Voigtländer
Zentralblatt für Chirurgie - Zeitschrift für Allgemeine, Viszeral-, Thorax- und Gefäßchirurgie.2022; 147(04): 398. CrossRef - Intraductal fully covered self-expanding metal stents in the management of post-liver transplant anastomotic strictures: a UK wide experience
Wafaa Ahmed, Dave Kyle, Amardeep Khanna, John Devlin, David Reffitt, Zeino Zeino, George Webster, Simon Phillpotts, Robert Gordon, Gareth Corbett, William Gelson, Manu Nayar, Haider Khan, Matthew Cramp, Jonathan Potts, Waleed Fateen, Hamish Miller, Bharat
Therapeutic Advances in Gastroenterology.2022;[Epub] CrossRef - Incidents and risk factors of biliary complications after orthotropic liver transplantation
Samir Zeair, Robert Stasiuk, Labib Zair, Marta Wawrzynowicz-Syczewska, Anita Rybicka, Elżbieta Grochans, Arkadiusz Kazimierczak
Medicine.2021; 100(34): e26994. CrossRef - Biliary complications in recipients of living donor liver transplantation: A single-centre study
Reginia Nabil Guirguis, Ehab Hasan Nashaat, Azza Emam Yassin, Wesam Ahmed Ibrahim, Shereen A Saleh, Mohamed Bahaa, Mahmoud El-Meteini, Mohamed Fathy, Hany Mansour Dabbous, Iman Fawzy Montasser, Manar Salah, Ghada Abdelrahman Mohamed
World Journal of Hepatology.2021; 13(12): 2081. CrossRef - Management of Post-Transplant Anastomotic Stricture Using Self-Expandable Metal Stent
Dong Wook Lee, Kazuo Hara
Clinical Endoscopy.2020; 53(3): 261. CrossRef - A unique type of fully covered metal stent for the management of post liver transplant biliary anastomotic strictures
Ben Warner, Phillip Harrison, Muhammad Farman, John Devlin, David Reffitt, Yasser El-Sherif, Shirin E. Khorsandi, Andreas Prachalias, Miriam Cortes Cerisuelo, Krish Menon, Wayel Jassem, Parthi Srinivasan, Hector Vilca-Melendez, Michael Heneghan, Nigel Hea
BMC Gastroenterology.2020;[Epub] CrossRef - The first experience with the fully-covered self-expandable nitinol stents in the management of anastomotic biliary strictures after orthotopic liver transplantation
A. V. Shabunin, I. Yu. Korzheva, G. M. Chechenin, S. S. Lebedev, P. A. Drozdov, O. S. Zhuravel, S. A. Astapovich
Almanac of Clinical Medicine.2020; 48(3): 171. CrossRef - Endoscopic Management of Biliary Issues in the Liver Transplant Patient
James F. Crismale, Jawad Ahmad
Gastrointestinal Endoscopy Clinics of North America.2019; 29(2): 237. CrossRef - Endoscopic management of anastomotic stricture after living-donor liver transplantation
Dong Wook Lee, Jimin Han
The Korean Journal of Internal Medicine.2019; 34(2): 261. CrossRef - Efficacy of Nasobiliary Tubes and Biliary Stents in Management of Patients with Bile Leak after Liver Transplantation: A Systematic Review
Ali Raza, Anam Omer, Sara Iqbal, Vineet Gudsoorkar, Pramoda Koduru, Kumar Krishnan
Clinical Endoscopy.2019; 52(2): 159. CrossRef - Endoscopic management of biliary strictures post-liver transplantation
Ahmed Akhter, Patrick Pfau, Mark Benson, Anurag Soni, Deepak Gopal
World Journal of Meta-Analysis.2019; 7(4): 120. CrossRef - Liver transplant–related anastomotic biliary strictures: a novel, rapid, safe, radiation-sparing, and cost-effective management approach
Monique T. Barakat, Robert J. Huang, Nirav C. Thosani, Abhishek Choudhary, Mohit Girotra, Subhas Banerjee
Gastrointestinal Endoscopy.2018; 87(2): 501. CrossRef - Long‐term outcomes of early compared to late onset choledochocholedochal anastomotic strictures after orthotopic liver transplantation
Sanjaya K. Satapathy, Imran Sheikh, Bilal Ali, Fazal Yahya, Mehmet Kocak, Laxmi Babu Parsa, James D. Eason, Jason M. Vanatta, Satheesh P. Nair
Clinical Transplantation.2017;[Epub] CrossRef - Challenges of Endoscopic Management of Pancreaticobiliary Complications in Surgically Altered Gastrointestinal Anatomy
Tin Moe Wai, Eun Young Kim
Clinical Endoscopy.2016; 49(6): 502. CrossRef
- Less is more: The use of single biodegradable stenting to treat biliary anastomotic strictures in pediatric liver transplantation
- 9,746 View
- 191 Download
- 17 Web of Science
- 16 Crossref
Case Report
- A Case of Biliary Cast Syndrome in a Non-liver Transplant Patient
- Sung Gon Jun, M.D., Seong Ran Jeon, M.D., Jong Ho Moon, M.D. and Young Deok Cho, M.D.
- Korean J Gastrointest Endosc 2011;42(6):419-423. Published online June 17, 2011
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Abstract
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- Biliary casts are uncommon but are typically seen in post-liver transplant patients, whereas very few cases have been reported in non-liver transplant patients. A 65- year-old man, who had not undergone a liver transplantation or other hepatobiliary surgery, presented with jaundice and fever. Radiological imaging studies showed diffuse thickening and enhancement of the intrahepatic duct with mild ductal dilatation and multiple linear filling defects. A percutaneous transhepatic cholangioscopy revealed severe bile duct inflammation and multiple biliary casts, which were removed with multiple percutaneous choledocoscopic procedures. The pathogenesis of the biliary casts in this patient was uncertain. However, we presumed that biliary tract infection with subsequent extensive cholangitis was an important predisposing factor in the cast formation. We report a case of biliary cast syndrome with no preexisting morbidity that was managed favorably with endoscopic removal.
- 2,613 View
- 18 Download
- Two Cases of Percutaneous Transhepatic Choledochoscopy Treatment of Intrahepatic Duct Stones that Occurred after Living Donor Liver Transplantation
- Byung Jun Lee, M.D., Jong Yun Won, M.D.*, Nu Ri Chon, M.D., Se-Joon Lee, M.D. and Dong Ki Lee, M.D.
- Korean J Gastrointest Endosc 2008;36(5):318-323. Published online May 30, 2008
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Abstract
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- Percutaneous transhepatic cholangioscopy (PTCS) is the primary treatment option for general cases of intrahepatic duct stones. However, there are no reports on the use of PTCS for intrahepatic duct stones in patients who had undergone living donor liver transplantation (LDLT). We experienced two cases of successful intrahepatic stone removal by the use of PTCS in LDLT patients. With these cases, we have confirmed that PTCS management can be safely performed not only for a general bile duct stone, but also for a bile duct stone that develops in a patient that had previously undergone liver transplantation. (Korean J Gastrointest Endosc 2008;36:318-323)
- 1,971 View
- 11 Download
- A Case of Biliary Cast Syndrome with a Biliary Stricture and Suppurative Cholangitis after Liver Transplantation
- Jung Pil Suh, M.D., In Seok Lee, M.D., Jae Hyuck Chang, M.D., Jung Hyun Kwon, M.D., Won Haing Hur, M.D., Si Hyun Bae, M.D., Myung Gyu Choi, M.D., In Sik Chung, M.D. and Dong Goo Kim, M.D.*
- Korean J Gastrointest Endosc 2007;35(4):281-286. Published online October 30, 2007
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Abstract
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- Biliary complications after liver transplantation occur in 13∼35% of patients. Biliary cast syndrome, cast formation of biliary sludge along the bile duct, can develop in 4∼18% of liver transplant recipients, although the incidence rate is significantly decreasing due to the improvement of graft harvesting and preservation. It is very important that early diagnosis and effective management of biliary cast syndrome be performed when there is a bile duct stricture or dilatation associated with jaundice and cholangitis in the recipient after liver transplantation, due to the possibility of retransplantation and death of the patient from graft loss. We report a case of a biliary cast formed with suppurative cholangitis and extracted incidentally with a plastic biliary stent during an endoscopic procedure after cadaveric liver transplantation, in which the ERCP findings revealed a stricture at the anastomosis site of the common bile duct and cholangitis. (Korean J Gastrointest Endosc 2007;35:281-286)
- 2,429 View
- 11 Download
- Biliary Cast Successfully Removed by Percutaneous Transhepatic Cholangioscopy, and This Developed in a Patient Who Received Orthotopic Liver Transplantation
- Hong Jeoung Kim, M.D., Ki Tae Yoon, M.D., Seungmin Bang, M.D., Seung Woo Park, M.D., Si Young Song, M.D. and Jae Bock Chung, M.D.
- Korean J Gastrointest Endosc 2006;33(6):381-384. Published online December 30, 2006
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Abstract
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- "Biliary cast syndrome" describes a cast formed from retained lithogenic material, and this cast is morphologically confined to the bile duct; this develops in 4∼18% of liver transplant recipients. The pathogenesis of cast formation is not clearly understood. The proposing etiological factors for biliary cast syndrome include acute cellular rejection, a prolonged cold ischemic time, use of postoperative biliary drainage tubes and biliary infection. These casts are more likely to develop in the setting of hepatic ischemia and biliary stricture. Endoscopic and percutaneous cast extraction might achieve favorable results and this should be attempted before surgical therapy. We report here on a case of biliary cast syndrome that was secondary to orthotopic liver transplantation; this was successfully treated via percutaneous choledochoscopic removal. We also include a review of the literature. (Korean J Gastrointest Endosc 2006;33:381384)
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- Biliary Complications after Adult Liver Transplantation
- Sang Soo Lee, M.D., Kyu Taek Lee, M.D., Sun-Young Lee, M.D., Tea Wook Kang, M.D., Won Moon, M.D., Ji Young Hwang, M.D., Min Kyu Yu, M.D., Jong Kyun Lee, M.D., Seung Woon Paik, M.D., Jae-Won Joh, M.D.*, Suk-Koo Lee, M.D.*, Sang Heum Kim, M.D.† a
- Korean J Gastrointest Endosc 2006;32(2):94-100. Published online February 27, 2006
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Abstract
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- Background
/Aims: Recently, living donor liver transplantation (LDLT) has been frequently performed in Korea because of the limited availability of a cadaveric donor (CD). We evaluated the clinical features of patients with biliary complications after liver transplantation and we compared the incidence of biliary complications according to the type of donor and the anastomotic type of the biliary tract. Methods: Between May 1996 and July 2004, 300 patients (CDLT 102/LDLT 198) underwent liver transplantation at Samsung Medical Center. The patients who experienced biliary complications during the follow-up period were enrolled to the study and we retrospectively reviewed their cases. Results: Sixty-seven cases (23%) of biliary complications were noticed in 53 patients (18%). The complications consisted of 20 cases (7%) of bile leakage, 38 cases (13%) of biliary strictures, 7 cases (2%) of biliary stones, and 2 cases (1%) of biliary stenosis due to other cause. There was no significant difference on the incidence of complications between CDLT (15/102; 14.7%) and LDLT (38/198; 19.2%) (p=0.42). In addition, there was no significant difference between choledocho-choledochostomy (43/237; 18.1%) and hepatico-jejunostomy (10/ 63; 15.9%)(p=0.85) Conclusions: The incidence rate of biliary complication after liver transplantation was 23%, and there was no difference according to the type of donor and the anastomotic type of biliary tract. (Korean J Gastrointest Endosc 2006;32:94100)
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