ndoscopic Therapy of Posttransplant Biliary Stenoses After ight-Sided Adult Living Donor Liver Transplantation

c p t ackground & Aims: Endoscopic treatment of biliary trictures after liver transplantation is a therapeutic hallenge. In particular, outcomes of endoscopic therpy of biliary complications in the case of duct-to-duct nastomosis after living related liver transplantation are imited. The aim of this study was to evaluate the feaibility and success of an endoscopic treatment aproach to posttransplant biliary strictures (PTBS) after ight-sided living donor liver transplantation (RLDLT) ith duct-to-duct anastomosis. Methods: Ninety patients ho received adult-to-adult RLDLT in our center were creened retrospectively with respect to endoscopic reatment of PTBS. Therapy was judged as successful hen cholestasis parameters returned to normal and ile duct narrowing was reduced significantly after the ompletion of therapy. Results: Forty of 90 RLDLT paients received duct-to-duct anastomosis, 12 (30%) howed PTBS. Seven of 12 patients were treated sucessfully by endoscopy; the remaining 5 patients were reated primarily by surgery. Most patients were treated y balloon dilatation followed by insertion of endoprosheses. A median of 2.5 dilatation sessions were necesary and the median treatment duration was 8 months. ne patient developed endoscopy-treatable recurrent steosis, no surgical intervention was necessary. Mild pancretitis occurred in 7.9% and cholangitis in 5.3% of the rocedures. One minor bleeding episode occurred during phincterotomy. Bleeding was managed endoscopically. onclusions: Endoscopic therapy of adult-to-adult right iving related liver transplantation with duct-to-duct nastomosis is feasible and frequently is successful. The uct-to-duct anastomosis offers the possibility of endocopic treatment. Endoscopic treatment of posttranslant biliary strictures is safe, with a low specific comlication rate.