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Khubutiya M.Sh.

Sklifosovsky Research Institute for Emergency Care

Kurenkov A.V.

Sklifosovsky Research Institute for Emergency Care

Teterin Yu.S.

Sklifosovsky Research Institute for Emergency Care

Yartsev P.A.

Sklifosovsky Research Institute for Emergency Care

Novruzbekov M.S.

Sklifosovsky Research Institute for Emergency Care

Endoscopic intraluminal treatment of early biliary complications after orthotopic liver transplantation

Authors:

Khubutiya M.Sh., Kurenkov A.V., Teterin Yu.S., Yartsev P.A., Novruzbekov M.S.

More about the authors

Journal: Pirogov Russian Journal of Surgery. 2023;(8): 13‑19

DOI: 10.17116/hirurgia202308113

Views: 1433

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Table of contents

ENDOSCOPIC INTRALUMINAL TREATMENT OF EARLY BILIARY COMPLICATIONS AFTER ORTHOTOPIC LIVER TRANSPLANTATION
ENDOSCOPIC INTRALUMINAL TREATMENT OF EARLY BILIARY COMPLICATIONS AFTER ORTHOTOPIC LIVER TRANSPLANTATION

To cite this article:

Khubutiya MSh, Kurenkov AV, Teterin YuS, Yartsev PA, Novruzbekov MS. Endoscopic intraluminal treatment of early biliary complications after orthotopic liver transplantation. Pirogov Russian Journal of Surgery. 2023;(8):13‑19. (In Russ., In Engl.)
https://doi.org/10.17116/hirurgia202308113

Подписка 2025-2 (Pirogov Russian Journal of Surgery)
МСФ на ЯМ
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OBJECTIVE

To improve the outcomes after orthotopic liver transplantation (OLT) followed by early biliary complications via endoscopic bilioduodenal stenting.

MATERIAL AND METHODS

The study enrolled 41 patients with early biliary complications within 90 days after OLT. All patients underwent endoscopic treatment between 2001 and 2021. There were 34 (82.9%) men and 7 (17.1%) women aged 48.5±12.5 years. Strictures and failure of biliary anastomosis occurred in 33 (80.5%) and 8 (19.5%) patients, respectively.

RESULTS

After endoscopic treatment, serum bilirubin normalized in 3.3±0.86 days in patients with strictures (23.7 (16.4; 34.5) mmol/l, p<0.001). Diameter of lobar ducts as a criterion of biliary hypertension was normalized after 4 (2.5; 5.5) days (p<0.001). Bile leakage after stenting with a covered self-expanding stent regressed in all 7 patients after 3 (2; 5) days. In 1 patient, bile output through the drainage stopped in 8 days after bilioduodenal stenting with a plastic stent.

CONCLUSION

Endoscopic bilioduodenal stenting is always effective and minimally invasive treatment after liver transplantation followed by early biliary complications (failure or stricture of anastomosis). This approach minimizes postoperative complications (9.8%) that do not require surgical intervention (Clavien-Dindo grade I).

Keywords:

bilioduodenal stenting
biliary complications
orthotopic liver transplantation
biliary anastomosis

Authors:

Khubutiya M.Sh.

Sklifosovsky Research Institute for Emergency Care

Kurenkov A.V.

Sklifosovsky Research Institute for Emergency Care

Teterin Yu.S.

Sklifosovsky Research Institute for Emergency Care

Yartsev P.A.

Sklifosovsky Research Institute for Emergency Care

Novruzbekov M.S.

Sklifosovsky Research Institute for Emergency Care

Received:

16.08.2022

Accepted:

10.10.2022

List of references:

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  2. Hampe T, Dogan A, Encke J, Mehrabi A, Schemmer P, Schmidt J, Stiehl A, Sauer P. Biliary complications after liver transplantation. Clinical Transplantation. 2006;20(suppl 17):93-96.  https://doi.org/10.1111/j.1399-0012.2006.00607.x
  3. Kochhar G, Parungao J.M, Hanouneh IA, Parsi A. Biliary complications following liver transplantation. World Journal of Gastroenterology. 2013;19(19):2841-2846. https://doi.org/10.3748/wjg.v19.i19.2841
  4. Davidson BR, Rai R, Kurzawinski TR, Selves L, Farouk M, Dooley JS, Burroughs AK, Rolles K. Prospective randomized trial of end-to-end versus side-to-side biliary reconstruction after orthotopic liver transplantation. British Journal of Surgery. 1999;86(4):447-452.  https://doi.org/10.1046/j.1365-2168.1999.01073.x
  5. Pascher A, Neuhaus P. Biliary complications after deceased-donor orthotopic liver transplantation. Journal of Hepato-biliary-Pancreatic Surgery. 2006;13(6):487-496.  https://doi.org/10.1007/s00534-005-1083-z
  6. Scatton O, Meunier B, Cherqui D, Boillot O, Sauvanet A, Boudjema K, Launois B, Fagniez PL, Belghiti J, Wolff P, Houssin D, Soubrane O. Randomized trial of choledochocholedochostomy with or without a T tube in orthotopic liver transplantation. Annals of Surgery. 2001;233(3):432-437.  https://doi.org/10.1097/00000658-200103000-00019
  7. Voskanyan SE, Popov MV, Artemiev AI, Sushkov AI, Kolyshev IYu, Rudakov VS, Maltseva AP, Zabezhinskiy DA. Bilary anastomotic strictures after right lobe living donor liver transplantation: a single-center experience. Khirurgiya. Zurnal im. N.I. Pirogova. 2021;(2):5-13. (In Russ.). https://doi.org/10.17116/hirurgia20210215
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  9. Sotiropoulos GC, Sgourakis G, Radtke A, Molmenti EP, Goumas K, Mylona S, Fouzas I, Karaliotas C, Lang H. Orthotopic liver transplantation: T-tube or not T-tube? Systematic review and meta-analysis of results. Transplantation. 2009;87(11):1672-1680. https://doi.org/10.1097/TP.0b013e3181a5cf3f
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