POSSIBILITIES OF VIDEO-CHOLANGIOSCOPY FOR DONOR CHOLEDOCHAL DETACHMENT IN A PATIENT AFTER ORTHOTOPIC LIVER TRANSPLANTATION
Abstract
Early post-transplant biliary complications are one of the most serious problems after orthotopic liver transplantation (OLT), their frequency varies from 10 to 35 %. Among them the most frequent are inconsistencies (from 7 to 25%) and strictures (from 4 to 9%) in the anastomosis area. Complete detachment of the edges of the biliary anastomosis area is usually the least amenable to endoscopic treatment; therefore, open surgical intervention from the laparatomic access should be strongly recommended. This article presents a rare clinical case of oral endoscopic transpapillary video cholangioscopy using Spy-glass system in a patient after orthotopic liver transplantation with complete diastasis of the biliary anastomosis edges. Use of Spy-glass video system allows performing direct visualization of the biliary tracts including small caliber, which provides an opportunity to carry out string-con-ductor even with complete diastasis of the anastomosis margins.
About the Authors
Yu. S. Teterin
N.V. Sklifosovsky Research Institute for Emergency Medicine of the Moscow Healthcare Department
Russian Federation
Russian Federation
M. Sh. Khubutia
N.V. Sklifosovsky Research Institute for Emergency Medicine of the Moscow Healthcare Department
Russian Federation
Russian Federation
P. A. Yartsev
N.V. Sklifosovsky Research Institute for Emergency Medicine of the Moscow Healthcare Department
Russian Federation
Russian Federation
L. L. Generdukayev
N.V. Sklifosovsky Research Institute for Emergency Medicine of the Moscow Healthcare Department
Russian Federation
Russian Federation
M. S. Novruzbekov
N.V. Sklifosovsky Research Institute for Emergency Medicine of the Moscow Healthcare Department
Russian Federation
Russian Federation
References
1. Charlton MR. Roadmap for improving patient and graft survival in the next 10 years. Liver Transpl. 2016;22(S1):71-78. doi: 10.1002/lt.24602
2. Girotra M, Soota K, Klair J.S, Dang S.M, Aduli F Endoscopic management of post-liver transplant biliary complications. World J Gastrointest Endosc. 2015;7(5):446-459. doi: 10.4253/wjge.v7.i5.446
3. Patel P DiNorcia J. The devil is in the detail: current management of perioperative surgical complications after liver transplantation. Curr Opin Organ Transplant. 2019;24(2):138-147. doi: 10.1097/M0T0000000000000616
4. Landi F, deAngelis N, Sepulveda A, MartHnez-PWez A, Sobhani I, Laurent A, et al. Endoscopic treatment of anastomotic biliary stricture after adult de-ceased donor liver transplantation with multiple plastic stents versus self-expandable metal stents: a systematic review and meta-analysis. Transpl Int. 2018;31(2):131-151. doi: 10.1111/tri.13089
5. Zeair S, Stasiuk R, Zair L, Wawrzynowicz-Syczewska M, Rybicka A, Grochans E, et al. Incidents and risk factors of biliary complications after orthotropic liver transplantation. Medicine (Baltimore). 2021; 100(34):e26994. doi: 10.1097/ MD.0000000000026994
6. Moy BT, Birk JW. A Review on the Management of Biliary Complications after Orthotopic Liver Transplantation. J Clin Transl Hepatol. 2019;7(1):61-71. doi: 10.14218/JCTH.2018.00028 Малое число наблюдений в настоящее время не позволяет провести статистически значимое сравнения с рентгенконтрастными методами, что требует дальнейших исследований в этой области.
7. Senter-Zapata M, Khan AS, Subramanian T, Vachharajani N, Dageforde LA, Wellen JR, et al. Patient and Graft Survival: Biliary Complications after Liver Transplantation J Am Coll Surg. 2018;226(4):484-494. doi: 10.1016/j. jamcollsurg.2017.12.039
8. Macнas-Gуmez C, Dumonceau JM. Endoscopic management of biliary complications after liver transplantation: an evidence-based review. World J Gastrointest Endosc. 2015;7(6):606-616. doi: 10.4253/wjge.v7.i6.606
9. Lee H.W, Shah N.H, Lee S.K. An Update on Endoscopic Management of Post-Liver Transplant Biliary Complications. Clin Endosc. 2017;50(5):451 -463, doi: 10.5946/ ce.2016.139
10. Lisotti A, Fusaroli P Caletti G. Role of endoscopy in the conservative management of biliary complications after deceased donor liver transplantation. World J Hepatol 2015;7(30):2927-2932. doi: 10.4254/wjh.v7.i30.2927
11. Crismale JF, Ahmad J. Endoscopic management of biliary issues in the liver transplant patient. Gastrointest Endosc Clin N Am. 2019;29(2):237-256. doi: 10.1016/j.giec.2018.11.003
12. Hbsing-Kabar A, Heinzow H.S, Schmidt H.H, Stenger C, Gerth H.U,Pohlen M, et al. Single-operator cholangioscopy for biliary complications in liver transplant recipients. World j Gastroenterol. 2017;23(22):4064-4071. doi: 10.3748/wjg. v23.i22.4064
Review
For citations:
Teterin Yu.S., Khubutia M.Sh., Yartsev P.A., Generdukayev L.L., Novruzbekov M.S. POSSIBILITIES OF VIDEO-CHOLANGIOSCOPY FOR DONOR CHOLEDOCHAL DETACHMENT IN A PATIENT AFTER ORTHOTOPIC LIVER TRANSPLANTATION. Filin’s Clinical endoscopy. 2021;(1):42-45. (In Russ.)
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