Endo-therapies for biliary duct-to-duct anastomotic stricture after liver transplantation: Outcomes of a nationwide survey

被引：21

作者：

Cantu, Paolo ^{[1
]}

Tarantino, Ilaria ^{[2
]}

Baldan, Anna ^{[3
]}

Mutignani, Massimiliano ^{[4
]}

Tringali, Andrea ^{[5
]}

Lombardi, Giovanni ^{[6
]}

Cerofolini, Angelo ^{[7
]}

Di Sario, Antonio ^{[8
]}

Catalano, Giorgia ^{[9
]}

Bertani, Helga ^{[10
]}

Ghinolfi, Davide ^{[11
]}

Boarino, Valentina ^{[12
]}

Masci, Enzo ^{[13
]}

Bulajic, Milutin ^{[14
]}

Pisani, Antonio ^{[15
]}

Fantin, Alberto ^{[16
]}

Ligresti, Dario ^{[2
]}

Barresi, Luca ^{[2
]}

Traina, Mario ^{[2
]}

Ravelli, Paolo ^{[3
]}

Forti, Edoardo ^{[4
]}

Barbaro, Federico ^{[5
]}

Costamagna, Guido ^{[5
]}

Rodella, Luca ^{[7
]}

Maroni, Luca ^{[8
]}

Salizzoni, Mauro ^{[9
]}

Conigliaro, Rita ^{[10
]}

Filipponi, Franco ^{[11
]}

Merighi, Alberto ^{[12
]}

Staiano, Teresa ^{[13
]}

Monteleone, Michela ^{[17
,18
]}

Mazzaferro, Vincenzo ^{[17
,18
]}

Zucchi, Elena ^{[14
]}

Zilli, Maurizio ^{[14
]}

Nadal, Elena ^{[16
]}

Rosa, Roberto ^{[1
,19
]}

Santi, Giulio ^{[1
,19
]}

Parzanese, Ilaria ^{[1
,19
]}

De Carlis, Luciano ^{[20
]}

Donato, Maria Francesca ^{[21
]}

Lampertico, Pietro ^{[19
,21
]}

Maggi, Umberto ^{[22
]}

Caccamo, Lucio ^{[22
]}

Rossi, Giorgio ^{[19
,22
]}

Vecchi, Maurizio ^{[1
,19
]}

Penagini, Roberto ^{[1
,19
]}

机构：

[1] Fdn IRCCS Ca Granda Osped Maggiore Policlin, Gastroenterol & Endoscopy Unit, Milan, Italy

[2] IRCCS, ISMETT Ist Mediterraneo Trapianti & Terapie Ad Al, Dept Diagnost & Therapeut Serv, Endoscopy Serv, Palermo, Italy

[3] Papa Giovanni XXIII Hosp, Dept Gastroenterol, Digest Endoscopy Unit, Bergamo, Italy

[4] Osped Niguarda Ca Granda, Diagnost & Intervent Digest Endoscopy, Milan, Italy

[5] Catholic Univ, Gemelli Univ Hosp, Digest Endoscopy Unit, Rome, Italy

[6] A Cardarelli Hosp, Digest Endoscopy Unit, Naples, Italy

[7] Borgo Trento City Hosp, Emergency Endoscopy Unit, Verona, Italy

[8] Polytech Marche Univ, United Hosp Ancona, Gastroenterol Clin, Dept Gastroenterol & Transplantat, Ancona, Italy

[9] Univ Turin, Molinette Hosp, AOU Citta Salute & Sci Torino, Liver Transplant Ctr & Gen Surg, Turin, Italy

[10] Nuovo Osped Civile St Agostino Estense, UOC Gastroenterol & Digest Endoscopy Unit, Modena, Italy

[11] Univ Pisa, Med Sch Hosp, Dept Oncol Transplants & Adv Med, Hepatobiliary Surg & Liver Transplantat Unit, Pisa, Italy

[12] Univ Policlin Modena, Azienda Osped, Gastroenterol & Endoscopy Unit, Modena, Italy

[13] Fdn IRCCS Ist Nazl Tumori, Diagnost & Therapeut Endoscopy Unit, Milan, Italy

[14] Univ Clin Hosp Santa Maria Misericordia, Udine, Italy

[15] Univ Bari, Dept Emergency & Organ Transplantat, Gastroenterol Sect, Bari, Italy

[16] Univ Padua, Azienda Osped, Dept Surg Oncol & Gastroenterol Sci, Div Gastroenterol, Padua, Italy

[17] Univ Milan, Liver Surg Transplantat & Gastroenterol, Milan, Italy

[18] Fdn IRCCS Ist Nazl Tumori, Milan, Italy

[19] Univ Milan, Milan, Italy

[20] Univ Milano Bicocca, Niguarda Ca Granda Hosp, Dept Gen Surg & Transplantat, Milan, Italy

[21] Univ Milan, Fdn IRCCS Ca Granda Osped Maggiore Policlin, Gastroenterol & Hepatol Unit, Milan, Italy

[22] Fdn IRCCS Ca Granda Osped Maggiore Policlin, Dept Pathophysiol & Transplantat, Gen Surg & Liver Transplantat Unit, Milan, Italy

来源：

LIVER INTERNATIONAL | 2019年 / 39卷 / 07期

关键词：

biliary anastomotic stricture; ERCP; fully covered metal stenting; liver transplantation; plastic multistenting; METAL STENTS; ENDOSCOPIC MANAGEMENT; PLASTIC STENTS; COMPLICATIONS; TRIAL; ERCP;

D O I：

10.1111/liv.14010

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

Background The most appropriate endo-therapeutic approach to biliary anastomotic strictures is yet to be defined. Aim To retrospectively report on the endo-therapy of duct-to-duct anastomotic strictures during 2013 in Italy. Methods Data were collected from 16 Endoscopy Units at the Italian Liver Transplantation Centers (BASALT study group). Results Complete endo-therapy and follow-up data are available for 181 patients: 101 treated with plastic multistenting, 26 with fully covered self-expandable metal stenting and 54 with single stenting. Radiological success was achieved for 145 patients (80%), that is, 88% of plastic multistenting, 88% of self-expandable metal stenting and 61% of single stenting (P P < 0.05 vs self-expandable metal stenting). After first-line endo-therapy failure, the patients underwent a second-line endo-therapy with plastic multistenting for 25%, fully covered self-expandable metal stenting for 53% and single stenting for 22% of cases, and radiological success was achieved for 84%, that is, 100%, 85% and 63% with plastic multistenting, self-expandable metal stenting and single stenting (P < 0.05 vs plastic multistenting or self-expandable metal stenting) respectively. Procedure-related complications occurred in 7.8% of endoscopic retrograde cholangiopancreatographies. Overall, clinical success was achieved in 87% of patients after a median follow-up of 25 months. Conclusion Plastic multistenting is confirmed as the preferred first-line treatment, while fully covered self-expandable metal stenting as rescue option for biliary anastomotic strictures. Single stenting has sub-optimal results and should be abandoned.

引用

页码：1355 / 1362

页数：8

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