Long-term outcome of endoscopic treatment of biliary strictures after liver transplantation

Biliary strictures are one of the most common complications following liver transplantation (LT), with an incidence 5.8-34%. Endoscopic techniques have been successfully used to treat biliary complications; however, the efficacy and safety of this treatment option has not yet been fully elucidated. This prospective study was to determine the efficacy and safety of endoscopic management of biliary complications after LT and its impact long-term patient and graft survival. Biliary strictures were suspected in the presence of elevated liver and/or abnormal abdominal sonography and subsequently diagnosed by endoscopic retrograde (ERC). The mean follow-up was 39.8 (range, 0.3-98.2) months after first ERC. Between October 1992 and 2003, a total of 515 patients underwent LT. Biliary complications were diagnosed in 84 patients (16.3 %). strictures (AS) alone were found in 65 (12.6%) and nonanastomotic strictures (NAS) in 19 patients (3.7%). success was observed in 77% of patients with AS. In patients with NAS, partial long-term responses could achieved in 63% of patients. Five patients (6.2%) required a percutaneous and 6 (7.4%) patients a surgical conclusion, the long-term outcome for patients with post-liver transplant biliary strictures after endoscopic is excellent, especially for patients with AS. Development of NAS reduces graft but not patient survival endoscopic therapy.