Journal
AMERICAN JOURNAL OF TRANSPLANTATION
Volume 23, Issue 4, Pages 573-576Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.ajt.2022.12.020
Keywords
clinical research; practice; liver allograft function; dysfunction; benign anastomotic stricture; liver transplantation; hepatology
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Biliary anastomotic stricture (BAS) is a common complication of liver transplantation with limited effective treatment options. In this case series, a novel percutaneous laser stricturotomy treatment was shown to be safe and effective in 5 post-transplant patients with refractory BAS. The laser excision and promotion of biliary re-epithelization yielded a 100% technical success rate and no recurrences at a mean follow-up time of 22 months.
Biliary anastomotic stricture (BAS) is a frequent complication of liver transplantation and is associated with reduced graft survival and patient morbidity. Existing treatments for BAS involve dilation of the stricture though placement of 1 or more catheters for 6 to 24 months yielding limited effectiveness in transplant patients. In this case series, we present preliminary safety and efficacy of a novel percutaneous laser stricturotomy treatment in a cohort of 5 posttransplant patients with BAS refractory to long-term large bore catheterization. In all patients, holmium or thulium laser was used to excise the stricture and promote biliary re-epithelization. There were no periprocedural complications. Technical success was 100% and at mean follow-up time of 22 months, there have been no recurrences. In conclusion, percutaneous laser stricturotomy demonstrates preliminary safety and efficacy in treatment of refractory BAS following liver transplantation.
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