Percutaneous Management of Post Liver Transplant Biliary (strictures) Complications in Pediatric Patients: A Single Center Experience

Background: The outcome of percutaneous management (PM) of post liver transplant biliary strictures (PLTBs) in pediatric age group. Method(s): Between august 2011 and December 2017, a total of 19 pediatric patients with (PLTBS) had pm. All patients presented with clinical and biochemical evidence of biliary obstruction. Biliary dilatation by imaging studies was seen in 17 patients. Protocol of three balloon dilatation sessions, at 4-6 weeks interval, is followed. Review of type of biliary anastomosis, status of the hepatic artery, outcome of the percutaneous management was carried out. Result(s): Out of the19 patients underwent pm for post-LT biliary strictures, 16 were successful with resolution of the clinical picture of biliary obstruction. One of the patients who failed PM was re-transplanted due to graft failure secondary to hepatic artery occlusion. The other two were surgically revised. The average number of dilatation sessions is 4.4 (2-9). The median age at first pm is 2.9 years (1-10). 13 patients were male and 6 were female.16 post living donor and 3 post cadaveric liver transplant. One patient has duct-to-duct anastomosis and the remaining has hepatico-jejunostomy. The median time from LT to first pm was 9.4 months (1-26). No complications were encountered. Conclusion(s): Pm of post liver transplant biliary strictures is safe and has very high success rate and surgery should be reserved for patients who have failed PM.

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Artikel online veröffentlicht:
11. Mai 2021