Endoscopic Treatment of Biliary Anastomotic Strictures After Liver Transplantation: Algorithmic Approach of a Single Tertiary Center
Surgical Laparoscopy, Endoscopy and Percutaneous Techniques, cilt.Publish Ahead of Print, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: Publish Ahead of Print
- Basım Tarihi: 2026
- Doi Numarası: 10.1097/sle.0000000000001442
- Dergi Adı: Surgical Laparoscopy, Endoscopy and Percutaneous Techniques
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CINAHL, EMBASE, MEDLINE
- Anahtar Kelimeler: liver transplantation, cholestasis, cholangiopancreatography, endoscopic retrograde, anastomosis, surgical, endoscopy, biliary stricture
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Background: – The optimal endoscopic strategy for postliver transplantation anastomotic strictures remains undefined. This study aimed to evaluate an algorithmic, stepwise approach based on stricture severity over a 13-year period. Methods: – This retrospective study included 78 patients treated between 2011 and 2024. Standard endoscopic passage of the anastomotic stricture using a guidewire was attempted in all cases. When this was unsuccessful, a percutaneous-endoscopic rendezvous procedure was performed; if the stricture remained impassable, a magnetic compression anastomosis was applied. Results: – A total of 613 procedures were performed. The proximal side of the stricture was successfully traversed by standard endoscopy in 55 patients (70.5%), by rendezvous in 15 (19.2%), and by magnetic compression in 8 (10.3%). Stent-free follow-up was achieved in 55 patients (70.5%), with a mean treatment duration of 12.3 months. Recurrence occurred in 10 patients (18.2%), and complications developed in 8.2% of procedures, most commonly stent migration. Conclusion: – A structured algorithm incorporating rendezvous and magnetic compression techniques can enhance overall success in complex post-transplant biliary strictures.