Alternative Techniques for Cannulation of Biliary Strictures Resistant to the 0.035" System Following Living Donor Liver Transplantation

• Published in: Korean journal of radiology Vol. 13; no. 2; pp. 189 - 194
• Main Authors: Yoon, Hee Mang, Kim, Jin Hyoung, Ko, Gi-Young, Song, Ho-Young, Gwon, Dong Il, Sung, Kyu-Bo
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Society of Radiology 01.03.2012; 대한영상의학회
• Subjects: Adult; Bile ducts; Bile Ducts - surgery; Catheterization - methods; Catheters; Constriction, Pathologic; Contrast agents; Endoscopy; Female; Fluoroscopy; Humans; Liver; Liver Transplantation; Living Donors; Male; Middle Aged; Original; Ostomy; Patients; Reoperation; Treatment Outcome; 방사선과학; United States > US; Biliary complications; Fluoroscopy; Endoscopy; Living donor liver transplantation
• ISSN: 1229-6929; 2005-8330; 2005-8330
• DOI: 10.3348/kjr.2012.13.2.189

To assess the clinical efficacy of alternative techniques for biliary stricture cannulation in patients undergoing living donor liver transplantation (LDLT), after cannulation failure with a conventional (0.035-inch guidewire) technique. Of 293 patients with biliary strictures after LDLT, 19 (6%) patients, 11 men and 8 women of mean age 48.5 years, had the failed cannulation of the stricture by conventional techniques. Recannulation was attempted by using two alternative methods, namely a micro-catheter set via percutaneous access and a snare (rendezvous) technique using percutaneous and endoscopic approaches. Strictures were successfully cannulated in 16 (84%) of the 19 patients. A microcatheter set was used in 12 and a snare technique in four patients. Stricture cannulation failed in the remaining three patients, who finally underwent surgical revision. Most technical failures using a conventional technique for biliary stricture cannulation after LDLT can be overcome by using a microcatheter set or a snare (rendezvous) technique.