Decai Kong, Xiaojing Zhang, Yangguang Yuan, Haoyu Duan, Junfeng Ye
{"title":"原位肝移植后胆道狭窄的内镜治疗及疗效分析：单中心回顾性研究。","authors":"Decai Kong, Xiaojing Zhang, Yangguang Yuan, Haoyu Duan, Junfeng Ye","doi":"10.2147/IJGM.S513603","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>The incidence of biliary stricture (BS) after liver transplantation (LT) significantly increases the risks of retransplantation and mortality. Although various endoscopic treatment strategies are available, a consensus is lacking in certain aspects, and the impact of endoscopic treatment on overall survival has yet to be studied. This retrospective study aims to explore factors influencing the efficacy of initial endoscopic treatment for BS after deceased donor orthotopic liver transplantation (OLT) and to analyze outcomes.</p><p><strong>Patients and methods: </strong>This research conducted a retrospective analysis of 89 patients who developed BS after OLT at The First Hospital of Jilin University between 01/01/2014 and 01/01/2022. Patients were categorized into a successful group (59 patients) and a failed group (30 patients) based on the success or failure of initial endoscopic treatment. Risk factor analysis for initial endoscopic treatment failure in patients with BS after OLT was performed using univariate and multivariate logistic regression analysis. The survival analysis for patients with BS after OLT was conducted using Cox regression and Kaplan-Meier methods.</p><p><strong>Results: </strong>The failure rate of initial endoscopic treatment was 33.7%. Independent risk factors for failure included the proximal and distal bile duct angle≤145 (<i>OR</i>=16.667, 95% <i>CI</i>: 3.279-83.333, <i>P</i>=0.001), severe stricture (<i>OR</i>=9.009, 95% <i>CI</i>: 1.590-50.000, <i>P</i>=0.013), and non-anastomotic stricture (NABS) type (<i>OR</i>=20.049, 95% <i>CI</i>: 2.663-150.953, <i>P</i>=0.004). Furthermore, failed initial endoscopic treatment (<i>HR</i>=3.205, 95% <i>CI</i>: 1.350-7.634, <i>P</i>=0.008) emerged as an independent risk factor for mortality in patients with BS after OLT.</p><p><strong>Conclusion: </strong>Initial endoscopic treatment for BS in patients after OLT is effective, safe, and has a high success rate. However, patients with the proximal and distal bile duct angle≤145, NABS, and severe strictures exhibit poorer initial endoscopic treatment effect. Those whose initial endoscopic treatment fails demonstrate significantly worse prognoses.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":"18 ","pages":"5883-5895"},"PeriodicalIF":2.0000,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12495928/pdf/","citationCount":"0","resultStr":"{\"title\":\"Endoscopic Treatment and Outcome Analysis of Biliary Stricture After Orthotopic Liver Transplantation: A Single Center Retrospective Study.\",\"authors\":\"Decai Kong, Xiaojing Zhang, Yangguang Yuan, Haoyu Duan, Junfeng Ye\",\"doi\":\"10.2147/IJGM.S513603\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>The incidence of biliary stricture (BS) after liver transplantation (LT) significantly increases the risks of retransplantation and mortality. Although various endoscopic treatment strategies are available, a consensus is lacking in certain aspects, and the impact of endoscopic treatment on overall survival has yet to be studied. This retrospective study aims to explore factors influencing the efficacy of initial endoscopic treatment for BS after deceased donor orthotopic liver transplantation (OLT) and to analyze outcomes.</p><p><strong>Patients and methods: </strong>This research conducted a retrospective analysis of 89 patients who developed BS after OLT at The First Hospital of Jilin University between 01/01/2014 and 01/01/2022. Patients were categorized into a successful group (59 patients) and a failed group (30 patients) based on the success or failure of initial endoscopic treatment. Risk factor analysis for initial endoscopic treatment failure in patients with BS after OLT was performed using univariate and multivariate logistic regression analysis. The survival analysis for patients with BS after OLT was conducted using Cox regression and Kaplan-Meier methods.</p><p><strong>Results: </strong>The failure rate of initial endoscopic treatment was 33.7%. Independent risk factors for failure included the proximal and distal bile duct angle≤145 (<i>OR</i>=16.667, 95% <i>CI</i>: 3.279-83.333, <i>P</i>=0.001), severe stricture (<i>OR</i>=9.009, 95% <i>CI</i>: 1.590-50.000, <i>P</i>=0.013), and non-anastomotic stricture (NABS) type (<i>OR</i>=20.049, 95% <i>CI</i>: 2.663-150.953, <i>P</i>=0.004). Furthermore, failed initial endoscopic treatment (<i>HR</i>=3.205, 95% <i>CI</i>: 1.350-7.634, <i>P</i>=0.008) emerged as an independent risk factor for mortality in patients with BS after OLT.</p><p><strong>Conclusion: </strong>Initial endoscopic treatment for BS in patients after OLT is effective, safe, and has a high success rate. However, patients with the proximal and distal bile duct angle≤145, NABS, and severe strictures exhibit poorer initial endoscopic treatment effect. Those whose initial endoscopic treatment fails demonstrate significantly worse prognoses.</p>\",\"PeriodicalId\":14131,\"journal\":{\"name\":\"International Journal of General Medicine\",\"volume\":\"18 \",\"pages\":\"5883-5895\"},\"PeriodicalIF\":2.0000,\"publicationDate\":\"2025-09-30\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12495928/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"International Journal of General Medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.2147/IJGM.S513603\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q2\",\"JCRName\":\"MEDICINE, GENERAL & INTERNAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of General Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.2147/IJGM.S513603","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
Endoscopic Treatment and Outcome Analysis of Biliary Stricture After Orthotopic Liver Transplantation: A Single Center Retrospective Study.
Purpose: The incidence of biliary stricture (BS) after liver transplantation (LT) significantly increases the risks of retransplantation and mortality. Although various endoscopic treatment strategies are available, a consensus is lacking in certain aspects, and the impact of endoscopic treatment on overall survival has yet to be studied. This retrospective study aims to explore factors influencing the efficacy of initial endoscopic treatment for BS after deceased donor orthotopic liver transplantation (OLT) and to analyze outcomes.
Patients and methods: This research conducted a retrospective analysis of 89 patients who developed BS after OLT at The First Hospital of Jilin University between 01/01/2014 and 01/01/2022. Patients were categorized into a successful group (59 patients) and a failed group (30 patients) based on the success or failure of initial endoscopic treatment. Risk factor analysis for initial endoscopic treatment failure in patients with BS after OLT was performed using univariate and multivariate logistic regression analysis. The survival analysis for patients with BS after OLT was conducted using Cox regression and Kaplan-Meier methods.
Results: The failure rate of initial endoscopic treatment was 33.7%. Independent risk factors for failure included the proximal and distal bile duct angle≤145 (OR=16.667, 95% CI: 3.279-83.333, P=0.001), severe stricture (OR=9.009, 95% CI: 1.590-50.000, P=0.013), and non-anastomotic stricture (NABS) type (OR=20.049, 95% CI: 2.663-150.953, P=0.004). Furthermore, failed initial endoscopic treatment (HR=3.205, 95% CI: 1.350-7.634, P=0.008) emerged as an independent risk factor for mortality in patients with BS after OLT.
Conclusion: Initial endoscopic treatment for BS in patients after OLT is effective, safe, and has a high success rate. However, patients with the proximal and distal bile duct angle≤145, NABS, and severe strictures exhibit poorer initial endoscopic treatment effect. Those whose initial endoscopic treatment fails demonstrate significantly worse prognoses.
期刊介绍：
The International Journal of General Medicine is an international, peer-reviewed, open access journal that focuses on general and internal medicine, pathogenesis, epidemiology, diagnosis, monitoring and treatment protocols. The journal is characterized by the rapid reporting of reviews, original research and clinical studies across all disease areas.
A key focus of the journal is the elucidation of disease processes and management protocols resulting in improved outcomes for the patient. Patient perspectives such as satisfaction, quality of life, health literacy and communication and their role in developing new healthcare programs and optimizing clinical outcomes are major areas of interest for the journal.
As of 1st April 2019, the International Journal of General Medicine will no longer consider meta-analyses for publication.
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