A novel approach in treating recurrent bilateral hepaticojejunostomy biliary strictures post-liver transplantation: Successful use of Simpson's atherectomy device.

Abstract

Biliary complications occur in 6% to 34% of patients who undergo orthotopic liver transplantation. Strictures at the anastomosis site or elsewhere in the biliary tract are common. These strictures are amenable to interventional radiological and surgical procedures; however, retransplantation is sometimes an inevitable outcome. An 8-year-old boy received combined liver and kidney transplants May 31, 1998. Hepatic artery thrombosis was diagnosed postoperative day 1 and treated with revascularization. The choledochojejunostomy was revised twice and resulted in a high hepaticojejunostomy. Significant strictures on both the right and left hepatic ducts at the anastomosis site were unsuccessfully treated by multiple interventional radiological procedures. The option of retransplantation was seriously explored. Simpson's atherectomy device was used in a novel approach February 24, 1999, and strictures on both ducts were successfully treated. At 1-year postprocedure, the patient has normal liver function with no evidence of recurrence of the strictures. Further experience with this novel technique is required to assess its role in treating biliary strictures post liver transplantation.

Cite this paper

@article{Rajadhyaksha2001ANA, title={A novel approach in treating recurrent bilateral hepaticojejunostomy biliary strictures post-liver transplantation: Successful use of Simpson's atherectomy device.}, author={Anjali M Rajadhyaksha and Dae-Yeon Kim and Raymond Chari and J J Frassica and William A. Primack and Eleanor Katz}, journal={Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society}, year={2001}, volume={7 2}, pages={142-6} }