Management of post-liver transplantation biliary stricture inaccessible by endoscopic retrograde cholangiopancreatography:A case report

作     者：Yohan Lee Chang Hwan Park Eunae Cho Ki-Hyun Kim 

作者机构：Division of Gastroenterology and HepatologyDepartment of Internal MedicineChonnam National University HospitalGwangju 61469South Korea 

出 版 物：《World Journal of Clinical Cases》 (世界临床病例杂志)

年 卷 期：2023年第11卷第34期

页      面：8235-8241页

核心收录：

学科分类：1002[医学-临床医学] 100210[医学-外科学(含：普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 10[医学] 

主　　题：Jaundice Obstructive Percutaneous transhepatic cholangioscopy Self-expandable metallic stents Case report 

摘      要：BACKGROUND One challenging scenario in the treatment of biliary stricture is that post-liver transplantation(LT)biliary strictures cannot be accessed using endoscopic retrograde cholangiopancreatography(ERCP).Here,we report such a case that was successfully treated using a novel endoscopic *** SUMMARY A 60-year-old man presented with obstructive jaundice caused by a post-LT biliary *** underwent LT for compensated alcoholic liver cirrhosis and hepatocellular *** investigations unveiled a cholestatic pattern of abnormalities in liver function and a total bilirubin level of 16 mg/*** resonance cholangiopancreatography revealed a stricture extending from the right intrahepatic bile duct into the common hepatic *** postoperative deformities made accessing the ampulla of Vater with a sideviewing duodenoscope *** transhepatic biliary drainage(PTBD)was performed to treat biliary ***,to resolve the stricture completely,a fully covered self-expandable metal stent(FC-SEMS)with a novel proximal retrievable string was deployed into the post-LT biliary stricture through the PTBD *** inserting the stent through the PTBD tract,the stent with the distal string was manually inverted to ensure that the distal part with the string became the proximal part for later endoscopic *** 6 mo,the FC-SEMS was successfully removed without complications,as the string was pulled out using a forward-viewing *** Deployment and endoscopic removal of an FC-SEMS with a novel proximal string through the PTBD tract may be a viable option for treating post-LT biliary strictures that are inaccessible by ERCP.