Retained surgical stents as a cause of biliary obstruction in pediatric liver transplants

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• 作者：John J. Crowley (1)
  Albert B. Zajko (2)
  Charles R. Fitz (1)
  Kyle A. Soltys (3)
  Jose L. Paredes (1)
  Vincent V. Mattiola (4)
  
  1. Department of Pediatric Radiology ; Children鈥檚 Hospital of Pittsburgh ; 4401 Penn Ave. Floor 2 ; Pittsburgh ; PA ; 15224 ; USA
  2. Department of Radiology ; University of Pittsburgh Medical Center ; Pittsburgh ; PA ; USA
  3. Thomas E. Starzl Transplant Institute ; Children鈥檚 Hospital of Pittsburgh ; University of Pittsburgh Medical Center ; Pittsburgh ; PA ; USA
  4. University of Pittsburgh ; Pittsburgh ; PA ; USA
  
• 关键词：Hepaticojejunostomy ; Biliary obstruction ; Biliary stent ; Liver transplantation ; Cholangiography ; Pediatric
• 刊名：Pediatric Radiology
• 出版年：2015
• 出版时间：March 2015
• 年：2015
• 卷：45
• 期：3
• 页码：430-434
• 全文大小：534 KB
• 参考文献：1. Zajko, AB, Bron, KM, Campbell, WL (1987) Percutaneous transhepatic cholangiography and biliary drainage after liver transplantation: a five-year experience. Gastrointest Radiol 12: pp. 137-143 CrossRef
  2. Zajko, AB, Campbell, WL, Bron, KM (1988) Diagnostic and interventional radiology in liver transplantation. Gastroenterol Clin North Am 17: pp. 105-143
  3. Buck, DG, Zajko, AB (2008) Biliary complications after orthotopic liver transplantation. Tech Vasc Interv Radiol 11: pp. 51-59 3/j.tvir.2008.05.006" target="_blank" title="It opens in new window">CrossRef
  
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Imaging and Radiology
  Pediatrics
  Neuroradiology
  Nuclear Medicine
  Ultrasound
  Oncology
  
• 出版者：Springer Berlin / Heidelberg
• ISSN：1432-1998

文摘

Background Small-caliber plastic stents are sometimes placed across the hepaticojejunostomy in liver transplant recipients at the time of biliary reconstruction. These stents usually pass spontaneously, but they can be retained and, rarely, this may cause biliary obstruction. Objective The purpose of this paper is twofold: to describe the appearance of biliary tract obstruction caused by retained surgical stents in pediatric liver transplants, and to report how these stents can be removed using interventional radiology techniques. Materials and methods Three pediatric patients presenting with biochemical and imaging evidence of biliary obstruction were encountered over a 6-month period. At percutaneous cholangiography all patients were found to have retained surgical stents which appeared to be causing biliary tract obstruction. Percutaneous snaring of the stents was undertaken. Results All stents were successfully removed using interventional radiology techniques, and follow-up showed no evidence of recurrent obstruction. Conclusion Surgical stents in children undergoing hepaticojejunostomy may be retained and cause biliary obstruction. Radiologists involved with imaging these patients should be aware of this potential cause of biliary obstruction. This complication is amenable to interventional radiology techniques with good long-term results. There is no easy endoscopic or surgical treatment option in these patients.