Efficacy of radiologic percutaneous interventional treatments for biliary complications after liver transplantation: Shiraz experience

Abstract

Background: Biliary complications are the leading cause of morbidity and mortality in patients undergoing liver transplantation (LT).Post- transplantation biliary strictures (BSs) are a serious problem with the high risk of graft failure. However, management of these BSs remains controversial, and considerable variability has been reported in results of percutaneous transhepatic radiologic intervention (PTRI) related to broad differences in technical procedures.

Objective: The aim of this study was to evaluate the efficacy of percutaneous treatments in the management of post-LT BSs in Shiraz center.

Methods: PTRI including balloon dilatation, metallic stent, and internal or internal-external handmade plastic stent insertion was done in thirty-four transplanted patients with BS referring to interventional radiology unit of Shiraz Namazi Hospital. Technical success rate, patency rates, and complications were evaluated.

Results: Thirty-one strictures were successfully treated without difference between the anastomotic and non-anastomotic type of stricture (success rate: 91.2%). 12- , 24- and 36-month primary patency rates were 90.1%, 84.5% and 76.8%, respectively. The secondary patency rate was 100% at 12 and 24 months and 93.3% at 26 and 60 months. The minor complication rate (mild cholangitis and hemobilia) was 6.4%, and no major complication occurred.

Conclusion: According to our experience, PTRI is an effective method of treating anastomotic and non-anastomotic strictures with high success rate and low complication.