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A novel approach in treating recurrent bilateral hepaticojejunostomy biliary strictures post–liver transplantation: Successful use of Simpson's atherectomy device
Author(s) -
Rajadhyaksha Amar,
Kim Ducksoo,
Chari Ravi,
Frassica Joseph,
Primack William,
Katz Eliezer
Publication year - 2001
Publication title -
liver transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.814
H-Index - 150
eISSN - 1527-6473
pISSN - 1527-6465
DOI - 10.1053/jlts.2001.21283
Subject(s) - medicine , liver transplantation , anastomosis , surgery , biliary tract , revascularization , transplantation , radiology , myocardial infarction
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.