Bolatbek Baimakhanov, Prof, PhD, MD, Yerlan Abdirashev, MD, Maksat Doskhanov, MD, Nurken Abdiyev, MD. JSC “National Scientific center of surgery named after A.N. Syzganov’s”
Background/Aims: The purpose is a retrospective analysis of endoscopic treatment (ET) of anastomotic strictures (AS) after LDLT and DDLT.
Methods: In the period from December 2015 to August 2018, we analyzed 107 patients after LT. LDLT was performed in 89 (83.1%) patients and DDLT in 18 (16.9%) patients. The whole liver in 18 (16.9%) patients, the right lobe in 81 (75.7%) patients, the left lobe in 7 (6.5%) patients, right posterior section in 1 (0.9%) patient. In 107 (100%) cases after LT in 25 (23.3%) patients BC of bile ducts were occurred. The early strictures (<90 days) of duct to duct anastomosis developed in 11 (44%) patients and 15 (54%) recipients developed late strictures (>720 days). The ET was performed to 20 (80%) patients. Other BC of 5 (20%) patients was solved by PTBD and open surgery.
Results: The retrograde ET was successful in 14 (70%) patients. In 11 (55%) cases we deployed plastic stent. To 3 (15%) patients only balloon dilation of AS was done. The 6 (30%) cases of ET were not effective. The main reasons were late diagnostic and treatment, severe stenosis of AS and unsufficient certain necessary equipments (guidewire, stents etc.). Also it was due to a small experience in this pathology. However, by growing of experience, the amount of successful ET increased.
Conclusions: Thus, ET on time is good solution to solve BC after LT. These category patients require careful and timely diagnosis of early BC (MRCP etc.), using single-use and sufficient quantity accessories, advanced experience of ERCP.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 91856
Program Number: P237
Presentation Session: Poster Session (Non CME)
Presentation Type: Poster