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. 2020 May;53(3):261-265.
doi: 10.5946/ce.2020.119. Epub 2020 May 29.

Management of Post-Transplant Anastomotic Stricture Using Self-Expandable Metal Stent

Dong Wook Lee  1 , Kazuo Hara  2
Affiliations

Management of Post-Transplant Anastomotic Stricture Using Self-Expandable Metal Stent

Dong Wook Lee et al. Clin Endosc. 2020 May.

Abstract

Anastomotic stricture (AS) is one of the complications of liver transplantation (LT) and can occur in up to 40% of living-donor LTs. Endoscopic management has become the first-line treatment of AS, and multiple plastic stents insertion has been mainly used in the past. Recently, many treatments utilizing fully covered self-expandable metal stents (cSEMSs) have been attempted, and results showing adequate treatment outcome have been reported. In this review, we look into the treatment performance and cautionary steps needed when using cSEMS as a treatment for AS.

Keywords: Constriction, pathologic; Liver transplantation; Self expandable metal stents.

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Conflict of interest statement

Conflicts of Interest: The authors have no financial conflicts of interest.

Figures

Fig. 1.
Fig. 1.
Procedure to place fully covered self-expandable metal stent (cSEMS) for the treatment of anastomotic stricture (AS). (A) A guidewire was inserted through the AS (arrow) after the selective cannulation of bile duct. (B) Balloon dilatation of stricture was performed before cSEMS insertion. (C) Successful deployment of cSEMS was achieved. (D) AS resolution (arrow) was observed 6 months after cSEMS insertion.
Fig. 2.
Fig. 2.
The algorithm used for fully covered self-expandable metal stent (cSEMS) insertion according to the level of the anastomotic stricture (AS). (A) cSEMS and plastic stent insertion can be considered if AS is close to proximal extrahepatic bile duct (EHD). (B) Only cSEMS insertion is enough if AS is close to distal EHD. IHD, intrahepatic bile duct.
See this image and copyright information in PMC

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