Role of percutaneous radiological treatment in biliary complications associated with adult left lobe living donor liver transplantation: a single-center experience

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dc.authoridYilmaz, Sezai/0000-0002-8044-0297
dc.authorwosidYilmaz, Sezai/ABI-2323-2020
dc.contributor.authorKaratoprak, Sinan
dc.contributor.authorKutlu, Ramazan
dc.contributor.authorYilmaz, Sezai
dc.date.accessioned2024-08-04T20:10:08Z
dc.date.available2024-08-04T20:10:08Z
dc.date.issued2021
dc.departmentİnönü Üniversitesien_US
dc.description.abstractPURPOSE Biliary complications develop at a higher rate in living donor liver transplantation (LDLT) compared with cadaveric liver transplantation. Almost all studies about biliary complications after LDLT were made with the right lobe. The aim of this study was to determine the frequency of biliary complications developing after adult left lobe LDLT and to evaluate the efficacy of the algorithm followed in diagnosis and treatment, particularly percutaneous radiological treatment. METHODS A total of 2185 LDLT operations performed in our center between May 2009 and December 2019 were retrospectively reviewed and patients receiving left lobe LDLT were analyzed regarding biliary complications and treatments. Biliary complications were treated via percutaneous drainage under ultrasound (US) guidance, endoscopic retrograde cholangiopancreatography (ERCP), and percutaneous transhepatic cholangiography (PTC)/ percutaneous transhepatic biliary drainage (PTBD). Patient demographics, ERCP procedures before percutaneous treatment, and percutaneous treatment indications were analyzed. RESULTS A total of 69 adult patients received left lobe LDLT. Biliary complications requiring endoscopic and/or percutaneous treatment developed in 28 patients (40%). Of these patients, 4 had bile leakage (14%), 20 had anastomosis stricture (72%), and 4 had both leakage and anastomosis stricture (14%). External drainage treatment under ultrasound guidance was sufficient for 2 of 4 patients with bile leakage, and these cases were accepted as minor bile leakage (7%). Overall, 26 patients underwent ERCP; of these, 8 were referred for PTC/PTBD because the guidewire and/or balloon-stent could not pass the anastomosis stricture (n=7) and common bile duct cannulation could not be obtained because of duodenal diverticulum (n=1). Diagnostic PTC was performed in 10 patients, 8 were referred after inadequate/failed ERCP procedure and two were referred directly without ERCP. Anastomosis stricture was found in 7 patients and anastomosis stricture and bile leakage in 3. In 7 patients determined to have stricture, balloon dilatation was applied and then biliary drainage was performed. In 3 patients who had leakage and anastomosis stricture, balloon dilatation was applied for stricture; after dilatation, an IEBD catheter was placed through the leakage region in 2 patients, while a covered metallic stent passing through the leakage region was placed in one patient. CONCLUSION Generally, ERCP is the first preferred method in biliary complications of LDLT; however, in cases where a response cannot be obtained by endoscopic treatment or require complex and/or aggressive treatment, percutaneous radiological treatment should be the treatment of choice before surgery in left lobe LDLT.en_US
dc.identifier.doi10.5152/dir.2021.20523
dc.identifier.endpage552en_US
dc.identifier.issn1305-3612
dc.identifier.issue4en_US
dc.identifier.pmid33599206en_US
dc.identifier.scopus2-s2.0-85112490367en_US
dc.identifier.scopusqualityQ2en_US
dc.identifier.startpage546en_US
dc.identifier.trdizinid448582en_US
dc.identifier.urihttps://doi.org/10.5152/dir.2021.20523
dc.identifier.urihttps://search.trdizin.gov.tr/yayin/detay/448582
dc.identifier.urihttps://hdl.handle.net/11616/92607
dc.identifier.volume27en_US
dc.identifier.wosWOS:000674747700014en_US
dc.identifier.wosqualityQ3en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakTR-Dizinen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherTurkish Soc Radiologyen_US
dc.relation.ispartofDiagnostic and Interventional Radiologyen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.subjectClassificationen_US
dc.subjectStricturesen_US
dc.subjectDrainageen_US
dc.subjectOutcomesen_US
dc.subjectGraftsen_US
dc.subjectRisken_US
dc.titleRole of percutaneous radiological treatment in biliary complications associated with adult left lobe living donor liver transplantation: a single-center experienceen_US
dc.typeArticleen_US

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