Digital single-operator cholangioscopy for biliary stricture after cadaveric liver transplantation  

作　　者：Jian-Feng Yu Dong-Lei Zhang Yan-Bin Wang Jian-Yu Hao 

机构地区：[1]Department of Gastroenterology,Beijing Chao-Yang Hospital,Capital Medical University,Beijing 100020,China

出　　处：《World Journal of Gastrointestinal Oncology》2022年第5期1037-1049,共13页世界胃肠肿瘤学杂志（英文版）（电子版）

摘　　要：BACKGROUND Biliary strictures after liver transplantation(LT)remain clinically arduous and challenging situations,and endoscopic retrograde cholangiopancreatography(ERCP)has been considered as the gold standard for the management of biliary strictures after LT.Nevertheless,in the treatment of biliary strictures after LT with ERCP,many studies show that there is a large variation in diagnostic accuracy and therapeutic success rate.Digital single-operator peroral cholangioscopy(DSOC)is considered a valuable diagnostic modality for indeterminate biliary strictures.AIM To evaluate DSOC in addition to ERCP for management of biliary strictures after LT.METHODS Nineteen patients with duct-to-duct biliary reconstruction who underwent ERCP for suspected biliary complications between March 2019 and March 2020 at Beijing Chaoyang Hospital,Capital Medical University,were consecutively enrolled in this observational study.After evaluating bile ducts using fluoroscopy,cholangioscopy using a modern digital single-operator cholangioscopy system(SpyGlass DS^(TM))was performed during the same procedure with patients under conscious sedation.All patients received peri-interventional antibiotic prophylaxis.Biliary strictures after LT were classified according to the manifestations of choledochoscopic strictures and the manifestations of transplanted hepatobiliary ducts.RESULTS Twenty-one biliary strictures were found in a total of 19 patients,among which anastomotic strictures were evident in 18(94.7%)patients,while non-anastomotic strictures in 2(10.5%),and space-occupying lesions in 1(5.3%).Stones were found in 11(57.9%)and loose sutures in 8(42.1%).A benefit of cholangioscopy was seen in 15(78.9%)patients.Cholangioscopy was crucial for selective guidewire placement prior to planned intervention in 4 patients.It was instrumental in identifying biliary stone and/or loose sutures in 9 patients in whom ERCP failed.It also provided a direct vision for laser lithotripsy.A spaceoccupying lesion in the bile duct was diagnosed by cholangi

关 键 词：CHOLANGIOSCOPY Endoscopic retrograde cholangiopancreatography Liver transplantation Biliary strictures Biliary complications Biliary anastomotic stricture 

分 类 号：R657.3[医药卫生—外科学]