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

Gastrointestinal Intervention Pub Date : 2018-07-31 DOI:10.18528/GII180012

S. Jang, D. Lee

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引用次数: 1

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 replace- ments 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. Copyright

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肝移植术后吻合口狭窄：不再是阿喀琉斯之踵！

肝移植（LT）后可能会出现胆道并发症，如胆道狭窄、吻合口瘘、胆总管结石和胆道铸型。在这些并发症中，胆道狭窄被认为是致命的弱点。近年来，吻合口胆管狭窄（ABS）的治疗已从传统的手术矫正过渡到非手术治疗模式。内镜下连续球囊扩张和/或多个塑料支架置换是非常有效的，目前被视为一线治疗方法。然而，如果患者已经通过肝肠造口术进行了吻合，则需要进行经皮治疗。随着最近的技术进步和交会方法，内镜和经皮ABS治疗的临床成功率有所提高，但这些方法在一些完全吻合口狭窄梗阻的患者中失败了。对于这些患者，建议将磁压缩吻合（MCA）作为一种替代方法。动物和人体研究已经证明了MCA的安全性和有效性，这些非手术方法的进步提高了ABS的临床成功率。本文综述了LT后发展的ABSs，并讨论了各种非手术方法的临床结果和未来的发展方向。版权

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Gastrointestinal Intervention

自引率

0.00%

发文量

审稿时长

24 weeks

期刊介绍： IJGII (pISSN 2636-0004, eISSN 2636-0012) was published four times a year on the last day of January, April, July, and October, which has effected from January 1 in 2019. This Journal was first published biannually on June and December, beginning in December 2012 under the title ‘Gastrointestinal Intervention’ (former pISSN 2213-1795, eISSN 2213-1809) and was changed to be published three times a year from 2016. Commencing with the January 2019 issue, the Journal was renamed ‘International Journal of Gastrointestinal Intervention’. As the official journal of the Society of Gastrointestinal Intervention (SGI), International Journal of Gastrointestinal Intervention (IJGII) delivers original, peer-reviewed articles for gastroenterologists, interventional radiologists, surgeons, gastrointestinal oncologists, nurses and technicians who need current and reliable information on the interventional treatment of gastrointestinal and hepatopancreaticobiliary diseases. Regular features also include ‘state-of-the-art’ review articles by leading authorities throughout the world. IJGII will become an international forum for the description and discussion of the various aspects of interventional radiology, endoscopy and minimally invasive surgery.