Efficacy of endoscopic and percutaneous treatments for biliary complications after cadaveric and living donor liver transplantation Ju Sang Park, MD,

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Presentation transcript:

Efficacy of endoscopic and percutaneous treatments for biliary complications after cadaveric and living donor liver transplantation Ju Sang Park, MD, Myung-Hwan Kim, MD, Sung Koo Lee, MD, Dong Wan Seo, MD, Sang Soo Lee, MD, Jimin Han, MD, Young Il Min, MD, Shin Hwang, MD, Kwang Min Park, MD, Young Joo Lee, MD, Seung Gyu Lee, MD, Kyu Bo Sung, MD Gastrointestinal Endoscopy Volume 57, Issue 1, Pages 78-85 (January 2003) DOI: 10.1067/mge.2003.11 Copyright © 2003 American Society for Gastrointestinal Endoscopy Terms and Conditions

Fig. 1 A, Retrograde cholangiogram showing biliary stricture (large arrow) at anastomotic site and bile duct stones (small arrow) distal to stricture. B, Retrograde cholangiogram after stone removal with balloon (small arrow) showing significant biliary stricture (large arrow). C, Retrograde cholangiogram made by means of nasobiliary tube 2 days after balloon dilation showing persistent stricture (arrow). A plastic stent was placed across stricture. Gastrointestinal Endoscopy 2003 57, 78-85DOI: (10.1067/mge.2003.11) Copyright © 2003 American Society for Gastrointestinal Endoscopy Terms and Conditions

Fig. 2 A, Retrograde cholangiogram showing contrast leakage (arrow) from site of T-tube removal. B, Retrograde cholangiogram 2 weeks after endoscopic sphincterotomy and nasobiliary tube drainage showing persistent leakage of contrast (arrow). A plastic stent was placed. C, Retrograde cholangiogram 2 months after stent removal showing no further leakage of contrast from leak site (arrow). Gastrointestinal Endoscopy 2003 57, 78-85DOI: (10.1067/mge.2003.11) Copyright © 2003 American Society for Gastrointestinal Endoscopy Terms and Conditions

Fig. 3 A, Cholangiogram made by PTBD tube showing multiple intrahepatic duct stones (small arrows) and long biliary stricture (arrowheads) at hepaticojejunostomy. A portal vein stricture was treated by insertion of a metal stent (large arrow). B, Cholangiogram made after stone removal from posterior intrahepatic duct. Stones are being removed from anterior intrahepatic duct with basket (small arrow) by means of a new PTBD tract (large arrow) because acute angulation between anterior and posterior intrahepatic ducts precluded an approach to anterior duct through posterior duct. C, Cholangiogram showing balloon dilation (arrow) of anastomotic stricture at hepaticojejunostomy. D, Cholangiogram made 1 month later showing clearance of stones and resolution of anastomotic stricture (arrowheads). Gastrointestinal Endoscopy 2003 57, 78-85DOI: (10.1067/mge.2003.11) Copyright © 2003 American Society for Gastrointestinal Endoscopy Terms and Conditions

Fig. 4 Kaplan-Meier curves showing occurrence rates of biliary complications in relation to type of bile duct reconstruction. A, Biliary stricture; B, biliary stone; C, bile leak. C-C, Choledochocholedochostomy; H-J, hepaticojejunostomy. Gastrointestinal Endoscopy 2003 57, 78-85DOI: (10.1067/mge.2003.11) Copyright © 2003 American Society for Gastrointestinal Endoscopy Terms and Conditions