A New Percutaneous Biliary Path With a Biodegradable Stent for Intrahepatic Biliary Stenosis After Living Donor Pediatric Liver Transplant.

Biliary tract complications are a significant source of morbidity following living donor liver transplant, especially in pediatric patients. These complications are influenced by graft type, bile duct anatomy, and reconstruction techniques. For a hepaticojejunostomy, percutaneous intervention is the first option preferred. Here, we present a case report of the successful use of a percutaneous biodegradable stent to manage an intrahepatic biliary stricture in an 8-month-old patient who had previously undergone living donor liver transplant for biliary atresia, thereby creating a new biliary path. The patient developed a dominant biliary stricture of segment S2 postoperatively, which was refractory to conventional internal drainage. We created a new biliary path via a novel connection between the intrahepatic duct and the intestinal loop with minimally invasive surgery. The biodegradable stent provided temporary structural support while gradually degrading, which eliminated the need for removal and minimized long-term complications. At 18 month follow-up, the patient remained asymptomatic with satisfactory liver function tests and no evidence of restenosis. This case illustrates the feasibility, safety, and potential benefits of biodegradable stents in pediatric liver transplant recipients. The findings suggest that biodegradable stents could represent a significant advancement in the management of complex biliary tract complications in children, although further studies are necessary to establish the long-term efficacy of this treatment and standardize the protocols.