Background And Aim: Biliary complications are an important cause of mortality and morbidity after living donor liver transplantation (LDLT). We present our endoscopic treatment results after LDLT as a single center with high volume.
Methods: Patients who underwent endoscopic retrograde cholangiopancreatography (ERCP) after LDLT between 2005 and 2015 were included. Clinical data included patient demographics, ERCP indications (stricture or leak), and treatment outcomes, including need for percutaneous and surgical interventions.
Results: ERCP was performed in 446 (39.2%) patients with duct-to-duct anastomosis of 1136 LDLT patients. The most common biliary complication was stricture ± stone (70.6%, 315/446). Stricture and leak occurred in 60 (13.4%) patients. Only biliary leak was found in 40 (8.9%) patients. Our endoscopic treatment success rate in patients with biliary stricture after LDLT was 65.1%. Overall endoscopic success rates in our patients were 55.0% in patients with both leak and stricture, and only leak. In all, our percutaneous transhepatic biliary interventions (PTBI) and ERCP success rate was 90.6% in patients with biliary complications after LDLT.
Conclusions: Endoscopic treatments are highly effective for biliary complications after LDLT. Effective use of percutaneous interventions in collaboration with endoscopic treatments significantly reduces the need for surgical treatment.
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"Biliary-cast syndrome" ("BCS") is most often encountered in clinical practice as a complication after liver transplantation, there are also described cases of biliary-cast syndrome in patients who did not undergo liver transplantation, isolated cases of "BCS" developing in patients with acute pancreatitis, choledocholithiasis are described in literature. Ischemic damage to bile duct epithelium with development of cholestasis and retrograde biliary tract infection are considered as the main etiological factors. This work presents a clinical case of "Biliary-cast syndrome" in a patient with acute biliary pancreatitis and pulmonary embolism.
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January 2025
Department of General Surgery, Shenzhen University General Hospital, Shenzhen 518000, Guangdong Province, China.
Background: Malignant obstructive jaundice (MOJ) is characterized by the presence of malignant tumors infiltrating or compressing the bile duct, causing poor bile drainage, generalized yellowing, pain, itching, and malaise. MOJ is burdensome for both the society and the families of affected patients and should be taken seriously.
Aim: To evaluate the clinical effect of stent placement during endoscopic retrograde cholangiopancreatography for relieving MOJ and the efficacy of percutaneous transhepatic biliary drainage in terms of liver function improvement, complication rates, and long-term patient outcomes.
World J Gastrointest Surg
January 2025
Department of Emergency Medicine, Biomedical Innovation Center, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou 510655, Guangdong Province, China.
Background: Hepatobiliary stone disease involves an intrahepatic bile duct stone that occurs above the confluence of the right and left hepatic ducts. One-step percutaneous transhepatic cholangioscopic lithotripsy (PTCSL) using the percutaneous transhepatic one-step biliary fistulation (PTOBF) technique enables the clearing of intrahepatic stones and the resolution of strictures. However, hepatolithiasis with associated strictures still has high residual and recurrence rates after one-step PTCSL.
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January 2025
Department of Hepatobiliary Surgery, Affiliated Nantong Hospital Third of Nantong University, Nantong 226006, Jiangsu Province, China.
Background: Intraoperative and postoperative biliary injuries remain significant complications of laparoscopic common bile duct exploration (LCBDE). Indocyanine green (ICG) has been shown to significantly reduce injuries caused by intraoperative operational errors. We found that the J-tube can reduce postoperative strictures and injuries to the common bile duct.
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December 2024
Hepatobiliary Surgery, Mater Misericordiae University Hospital, Townsville, AUS.
Left-sided gallbladder (LSGB) is a rare anatomical variation where the gallbladder is to the left of the falciform ligament and ligamentum teres. Most commonly, it is discovered as an incidental finding at the time of operation (typically for cholecystectomy). We describe a case of left-sided gallbladder in a 71-year-old female.
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