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Endoscopic management of bile leaks after liver transplantation: An analysis of two high-volume transplant centers.

ABSTRACT: Bile leak after liver transplantation (LT) is commonly treated with endoscopic retrograde cholangiopancreatography (ERCP); however, there are limited data regarding the optimal treatment strategy.We aimed to examine the role of ERCP in LT recipients with bile leaks at two large institutions.We reviewed all ERCPs performed in LT recipients with bile leak and duct-to-duct biliary anastomosis at two high-volume transplant centers.Eighty patients were included. Forty-seven (59%) patients underwent ERCP with plastic stent placement (with or without sphincterotomy) and 33 patients (41%) underwent sphincterotomy alone. Complete resolution was obtained in 94% of the stent group vs. 58% of the sphincterotomy group (p?

SUBMITTER: Sendino O

PROVIDER: S-EPMC5802677 | biostudies-literature | 2018 Feb

REPOSITORIES: biostudies-literature

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Endoscopic management of bile leaks after liver transplantation: An analysis of two high-volume transplant centers.

Sendino Oriol O Fernández-Simon Alejandro A Law Ryan R Abu Dayyeh Barham B Leise Michael M Chavez-Rivera Karina K Cordova Henry H Colmenero Jordi J Crespo Gonzalo G Rodriguez de Miguel Cristina C Fondevila Constantino C Llach Josep J Navasa Miquel M Baron Todd T Cárdenas Andrés A

United European gastroenterology journal 20170525 1

<h4>Background</h4>Bile leak after liver transplantation (LT) is commonly treated with endoscopic retrograde cholangiopancreatography (ERCP); however, there are limited data regarding the optimal treatment strategy.<h4>Objective</h4>We aimed to examine the role of ERCP in LT recipients with bile leaks at two large institutions.<h4>Methods</h4>We reviewed all ERCPs performed in LT recipients with bile leak and duct-to-duct biliary anastomosis at two high-volume transplant centers.<h4>Results</h4> ...[more]

PMID: 29435318

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Project description:Despite numerous advances and emerging data, liver transplantation in the setting of gastrointestinal malignancies remains controversial outside of certain accepted indications. In an era of persistent organ shortage and increasing organ demand, allocation of liver grafts must be considered carefully. While hepatocellular carcinoma and hilar cholangiocarcinoma have become accepted indications for transplantation, tumor size and standardized multi-disciplinary treatment protocols are necessary to ensure optimal patient outcomes. As more studies seeking to expand the oncologic indications for liver transplantation are emerging, it is becoming increasingly clear that tumor biology and response to therapy are key factors for optimal oncologic outcomes. In addition, time from diagnosis to transplantation appears to correlate with survival, as stable disease over time portends better outcomes post-operatively. Identifying aggressive disease pre-transplant remains difficult with current imaging and tissue sampling techniques. While tumor size and stage are important prognostic predictors for most malignancies, patient and tumor selection protocols are necessary. As the fields of medical and surgical oncology continue to evolve, it is clear that a protocolized interdisciplinary treatment approach is necessary for combatting any cancer effectively. Disease stability over time and response to neoadjuvant therapy may be the best predictors for successful patient outcomes and can be easily incorporated in our treatment paradigms. Current data evaluating liver transplantation for expanded oncologic indications such as: expanded criteria hepatocellular carcinoma, intrahepatic cholangiocarcinoma, mixed tumors, and liver limited metastatic colorectal carcinomas, incorporate multi-modal therapies and evaluation of tumor treatment response. While further investigation is necessary, initial results suggest there is an expanded role for transplant surgery in malignancy in a new era of liver transplant oncology.

Dataset Information

Endoscopic management of bile leaks after liver transplantation: An analysis of two high-volume transplant centers.

Publications

Endoscopic management of bile leaks after liver transplantation: An analysis of two high-volume transplant centers.

Similar Datasets

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