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Biodegradable Biliary Stents for Percutaneous Treatment of Post-liver Transplantation Refractory Benign Biliary Anastomotic Strictures

  • Clinical Investigation
  • Biliary
  • Published:
CardioVascular and Interventional Radiology Aims and scope Submit manuscript

Abstract

Purpose

The aim of this study was to evaluate the safety and the effectiveness of polydioxanone-made biodegradable biliary stent placement for the treatment of post-transplant benign, refractory biliary anastomotic strictures.

Materials and Methods

This was a retrospective observational study on all adult liver transplant recipients who developed a clinically significant anastomotic stricture between January 2014 and June 2017. Percutaneous transhepatic cholangioplasty with balloon dilation was performed as therapeutic approach in selected patients after multidisciplinary evaluation. Refractory strictures (defined as stricture persistence after two interventional procedures) were managed with placement of polydioxanone-made biodegradable biliary stent (SX-Ella biliary stent, Czech Republic). Patency of the common bile duct was calculated using Kaplan–Meier analysis.

Results

Eighteen adult liver transplant recipients who developed a refractory biliary anastomotic stricture [males/females 13/5, median (IQR) 58.2 (9.3) years] underwent biodegradable biliary stent placement after 10.4 (32) months from liver transplantation. All procedures except one were uneventful. After a median (IQR) follow-up time of 27.2 (22) months, complete resolution of anastomotic stricture was achieved in 72% of patients, with significant improvement on liver enzymes.

Conclusions

Polydioxanone-made biodegradable biliary stent might be a safe and effective therapeutic option for the difficult-to-treat benign biliary anastomotic stricture after liver transplantation.

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Abbreviations

AS:

Anastomotic stricture

BBS:

Biodegradable biliary stent

ERCP:

Endoscopic retrograde cholangiopancreatography

LT:

Liver transplantation

MRCP:

Magnetic resonance cholangiopancreatography

PDX:

Polydioxanone

PTC:

Percutaneous transhepatic cholangioplasty

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Author information

Author notes

  1. Michele Battistel and Marco Senzolo equally contributed to the study and should be considered as co-first authors.

Authors and Affiliations

  1. University Radiology Unit, Padua University Hospital, Padua, Italy

    Michele Battistel, Amalia Lupi, Roberto Stramare, Emilio Quaia & Giulio Barbiero

  2. Multivisceral Transplant Unit, Padua University Hospital, Padua, Italy

    Marco Senzolo, Alberto Ferrarese & Patrizia Burra

  3. Hepatobiliary Surgery and Liver Transplant Center, Padua University Hospital, Padua, Italy

    Umberto Cillo, Patrizia Boccagni & Giacomo Zanus

Authors
  1. Michele Battistel
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  2. Marco Senzolo
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  3. Alberto Ferrarese
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  4. Amalia Lupi
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  5. Umberto Cillo
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  6. Patrizia Boccagni
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  7. Giacomo Zanus
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  8. Roberto Stramare
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  9. Emilio Quaia
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  10. Patrizia Burra
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  11. Giulio Barbiero
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Corresponding author

Correspondence to Giulio Barbiero.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Standard

All procedures performed in this study were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The study was approved by the Institutional Review Board.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

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Consent for publication was obtained for every individual person’s data included in the study.

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Cite this article

Battistel, M., Senzolo, M., Ferrarese, A. et al. Biodegradable Biliary Stents for Percutaneous Treatment of Post-liver Transplantation Refractory Benign Biliary Anastomotic Strictures. Cardiovasc Intervent Radiol 43, 749–755 (2020). https://doi.org/10.1007/s00270-020-02442-4

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  • DOI: https://doi.org/10.1007/s00270-020-02442-4

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