Gut Liver.  2010 Mar;4(1):68-75.

Usefulness of the Rendezvous Technique for Biliary Stricture after Adult Right-Lobe Living-Donor Liver Transplantation with Duct-To-Duct Anastomosis

Affiliations
  • 1Department of Internal Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea. isle@catholic.ac.kr
  • 2Department of Radiology, The Catholic University of Korea College of Medicine, Seoul, Korea.
  • 3Department of Surgery, The Catholic University of Korea College of Medicine, Seoul, Korea.

Abstract

BACKGROUND/AIMS
Replacement of a percutaneous transhepatic biliary drainage (PTBD) catheter with inside stents using endoscopic retrograde cholangiography is difficult in patients with angulated or twisted biliary anastomotic stricture after living donor liver transplantation (LDLT). We evaluated the usefulness and safety of the rendezvous technique for the management of biliary stricture after LDLT.
METHODS
Twenty patients with PTBD because of biliary stricture after LDLT with duct-to-duct anastomosis underwent the placement of inside stents using the rendezvous technique.
RESULTS
Inside stents were successfully placed in the 20 patients using the rendezvous technique. The median procedure time was 29.6 (range, 7.5-71.8) minutes. The number of inside stents placed was one in 12 patients and two in eight patients. One mild acute pancreatitis and one acute cholangitis occurred, which improved within a few days. Inside stent related sludge or stone was identified in 12 patients during follow-up. Thirteen patients achieved stent-free status for a median of 281 (range, 70-1,351) days after removal of the inside stents.
CONCLUSIONS
The rendezvous technique is a useful and safe method for the replacement of PTBD catheter with inside stent in patients with biliary stricture after LDLT with duct-to-duct anastomosis. The rendezvous technique could be recommended to patients with angulated or twisted strictures.

Keyword

Rendezvous; Biliary stricture; Liver transplantation; Endoscopic retrograde cholangiography; Percutaneous transhepatic biliary drainage

MeSH Terms

Adult
Catheters
Cholangiography
Cholangitis
Constriction, Pathologic
Dioxolanes
Drainage
Fluorocarbons
Follow-Up Studies
Humans
Liver
Liver Transplantation
Living Donors
Pancreatitis
Sewage
Stents
Dioxolanes
Fluorocarbons
Sewage
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