Less is more: The use of a single biodegradable stenting to treat biliary anastomotic strictures in pediatric liver transplantation.

Autor:	Bernabeu JQ; Pediatric Hepatology and Liver Transplant Unit. Department of Pediatrics. Vall d'Hebron Hospital Campus, Barcelona. Spain. ERN Rare Liver ERN TransplantChild., Juamperez Goñi J; Pediatric Hepatology and Liver Transplant Unit. Department of Pediatrics. Vall d'Hebron Hospital Campus, Barcelona. Spain. ERN Rare Liver ERN TransplantChild., Hally MM; Pediatric Hepatology and Liver Transplant Unit. Department of Pediatrics. Vall d'Hebron Hospital Campus, Barcelona. Spain. ERN Rare Liver ERN TransplantChild., Padrós Fornieles C; Pediatric Hepatology and Liver Transplant Unit. Department of Pediatrics. Vall d'Hebron Hospital Campus, Barcelona. Spain. ERN Rare Liver ERN TransplantChild., Larrarte King M; Pediatric Hepatology and Liver Transplant Unit. Department of Pediatrics. Vall d'Hebron Hospital Campus, Barcelona. Spain. ERN Rare Liver ERN TransplantChild., Gahete JAM; Pediatric Surgery Department. Vall d'Hebron Hospital Campus, Barcelona. Spain., Muñoz AC; Pediatric Radiology Unit. Radiology Department. Vall d'Hebron Hospital Campus, Barcelona. Spain., Diez Miranda I; Interventional Radiology Unit. Radiology Department. Vall d'Hebron Hospital Campus, Barcelona. Spain., Pérez Lafuente M; Interventional Radiology Unit. Radiology Department. Vall d'Hebron Hospital Campus, Barcelona. Spain., Charco Torra R; HPB Surgery and Transplants Department. Vall d'Hebron Hospital Campus, Barcelona. Spain., Hidalgo Llompart E; HPB Surgery and Transplants Department. Vall d'Hebron Hospital Campus, Barcelona. Spain.
Jazyk:	angličtina
Zdroj:	Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society [Liver Transpl] 2024 Nov 22. Date of Electronic Publication: 2024 Nov 22.
DOI:	10.1097/LVT.0000000000000504
Abstrakt:	Objective: To report our experience of using biodegradable biliary stents for anastomotic biliary strictures in pediatric liver transplant patients. Methods: Analysis of a retrospective data collection from January 2014 to January 2023, including all pediatric liver transplant recipients in our center treated for anastomotic biliary strictures with biodegradable biliary stents (BBS). In phase 1 (2014-2019), there was an initial percutaneous transhepatic cholangiography (PTC) with anastomotic dilatation followed two weeks after by a second PTC with BBS insertion. In phase 2 (2019-2023), the BDS were placed shortly after anastomotic biliary strictures dilatation, requiring only one PTC. All patients were followed up with routine tests and ultrasound. Results: Forty-six anastomotic biliary strictures were diagnosed in 43 pediatric liver transplant recipients with a median of 6.7 months post-liver transplantation (0.1-246.8 months). Eight out of 46 anastomotic biliary strictures (17.4%) treated with biodegradable biliary stents relapsed (median recurrence time: 6.5 months; 1.6-17.0 months). Four resolved with further BBS placement; only four needed surgical revision (8.7%) after a median follow-up time of 43.9 months (0.3-106.3). There were no differences in anastomotic biliary strictures recurrence rate, time between stent placement and recurrence, or the presence of cholangitis based on whether the BBS was deployed in one or two steps. Patients with end-to-end anastomosis had a higher anastomotic biliary strictures recurrence (or 10.8; 1.4-81.3, p =0.008) than those with bilioenteric anastomosis. Conclusion: The use of biodegradable stents stents could be good option for treating anastomotic biliary strictures in pediatric liver transplant patients, with our series showing a success rate of over 90% and an average follow-up of 43.9 months. (Copyright © 2024 American Association for the Study of Liver Diseases.)
Databáze:	MEDLINE
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