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Park, Byun, Kim, Kim, Hwang, Kim, Choi, and Park: Percutaneous Balloon Dilatation and Catheter Maintenance Method in the Patients with Biliary Strictures after Living Donor Liver Transplantation
Interventional Radiology
Journal of the Korean Society of Radiology

Journal of the Korean Society of Radiology 2013; 68(4): 305-313.

Published online: 10 April 2013

DOI: https://doi.org/10.3348/jksr.2013.68.4.305

Percutaneous Balloon Dilatation and Catheter Maintenance Method in the Patients with Biliary Strictures after Living Donor Liver Transplantation

Dae Hong Park, MD1, Sung Su Byun, MD1, Jeong Ho Kim, MD1, Keon Kuk Kim, MD2, Hee Young Hwang, MD1, Hyung Sik Kim, MD1, Hye-Young Choi, MD1, Jae Hyung Park, MD1

1Department of Radiology, Gachon University School of Medicine, Gil Hospital, Incheon, Korea.

2Department of General Surgery, Gachon University School of Medicine, Gil Hospital, Incheon, Korea.

Corresponding author: Sung Su Byun, MD. Department of Radiology, Gachon University School of Medicine, Gil Hospital, 21 Namdong-daero 774beon-gil, Namdong-gu, Incheon 405-760, Korea. Tel. 82-32-460-3062, Fax. 82-32-460-3065, radbyun@hanmail.net

Received 6 January 2013       Accepted 25 January 2013

Copyright © 2013 The Korean Society of Radiology

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

The aim of this study was to evaluate the therapeutic efficacy of the percutaneous balloon dilatation and catheter maintenance (BDCM) method for postoperative biliary strictures following living donor liver transplantation (LDLT).

Materials and Methods

Eighteen patients (14 duct-to-duct anastomosis and 4 hepaticojejunostomy) with post-LDLT biliary stricture were treated by the percutaneous BDCM method. A good response was defined as residual stricture over 3.5 mm after repetitive BDCM and refractory response as residual stricture below 3.5 mm. If they demonstrated good results on follow-up studies after catheter withdrawal, all the patients quit the therapy. We evaluated the technical and clinical success rates, major complication rate, mean total procedure time and mean follow-up duration.

Results

The percutaneous BDCM method was technically successful without major complication. Nine patients improved biliary stricture (good response, mean 5.5 mm), and the other 9 patients showed residual stricture with the diameter below 3.5 mm (refractory response, mean 2.5 mm). However, all the patients were improved clinically without significant complication. The total procedure time was 1-15 months (mean 7.3 months) and follow-up duration was 6-54 months (mean 24 months).

Conclusion

The percutaneous BDCM method for post-LDLT biliary strictures was an effective therapy even in the patients showing a refractory response. It seemed that total procedure time could be reduced if the response was determined earlier.

Keywords: Living Donor Liver Transplantation, Biliary Stricture, Percutaneous Balloon Dilatation, Catheter Maintenance

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