Abstract
Purpose
The aim of this study was to evaluate the safety and the effectiveness of polydioxanone-made biodegradable biliary stent placement for the treatment of post-transplant benign, refractory biliary anastomotic strictures.
Materials and Methods
This was a retrospective observational study on all adult liver transplant recipients who developed a clinically significant anastomotic stricture between January 2014 and June 2017. Percutaneous transhepatic cholangioplasty with balloon dilation was performed as therapeutic approach in selected patients after multidisciplinary evaluation. Refractory strictures (defined as stricture persistence after two interventional procedures) were managed with placement of polydioxanone-made biodegradable biliary stent (SX-Ella biliary stent, Czech Republic). Patency of the common bile duct was calculated using Kaplan–Meier analysis.
Results
Eighteen adult liver transplant recipients who developed a refractory biliary anastomotic stricture [males/females 13/5, median (IQR) 58.2 (9.3) years] underwent biodegradable biliary stent placement after 10.4 (32) months from liver transplantation. All procedures except one were uneventful. After a median (IQR) follow-up time of 27.2 (22) months, complete resolution of anastomotic stricture was achieved in 72% of patients, with significant improvement on liver enzymes.
Conclusions
Polydioxanone-made biodegradable biliary stent might be a safe and effective therapeutic option for the difficult-to-treat benign biliary anastomotic stricture after liver transplantation.
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Abbreviations
- AS:
-
Anastomotic stricture
- BBS:
-
Biodegradable biliary stent
- ERCP:
-
Endoscopic retrograde cholangiopancreatography
- LT:
-
Liver transplantation
- MRCP:
-
Magnetic resonance cholangiopancreatography
- PDX:
-
Polydioxanone
- PTC:
-
Percutaneous transhepatic cholangioplasty
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All procedures performed in this study were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The study was approved by the Institutional Review Board.
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Battistel, M., Senzolo, M., Ferrarese, A. et al. Biodegradable Biliary Stents for Percutaneous Treatment of Post-liver Transplantation Refractory Benign Biliary Anastomotic Strictures. Cardiovasc Intervent Radiol 43, 749–755 (2020). https://doi.org/10.1007/s00270-020-02442-4
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DOI: https://doi.org/10.1007/s00270-020-02442-4