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Observational Study of Biliary Duct stenosis in patients with Post-Liver Transplant
Raul Sosa-Martinez1, Daniela A. Garcia-Alonso1, Julian Vargas-Flores1, Luis A. Waller-González2, Mayra V. Ramos-Gomez1
1 Gastroenterology department, Centro Médico Nacional 20 de noviembre, Mexico City
2 Endoscopy unit, Centro Médico Nacional 20 de noviembre, Mexico City
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        "autoresLista" => "Raul Sosa-Martinez, Daniela A. Garcia-Alonso, Julian Vargas-Flores, Luis A. Waller-González, Mayra V. Ramos-Gomez"
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="para0007" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Ethical statement</span></p><p id="para0008" class="elsevierStylePara elsevierViewall">The protocol was registered and approved by the Ethics Committee&#46; The identity of the patients is protected&#46; Consentment was obtained&#46;</p><p id="para0009" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Declaration of interests</span></p><p id="para0010" class="elsevierStylePara elsevierViewall">None</p><p id="para0011" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Funding</span></p><p id="para0012" class="elsevierStylePara elsevierViewall">This research did not receive any specific grant from funding agencies in the public&#44; commercial&#44; or not-for-profit sectors&#46;<elsevierMultimedia ident="fig0001"></elsevierMultimedia></p><p id="para0013" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Figure 1&#46;</span> Number of bile duct rehabilitiations and remission &#40;N&#61;39&#41;<elsevierMultimedia ident="fig0002"></elsevierMultimedia></p><p id="para0014" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Figure 2&#46;</span> Etiology of liver transplantation &#40;N&#61;39&#41;</p></span>"
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        "resumen" => "<span id="abss0001" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cesectitle0001">Introduction and Objectives</span><p id="spara001" class="elsevierStyleSimplePara elsevierViewall">Liver transplant is a surgical procedure indicated in terminal hepatic diseases or patients who fail any other type of treatment&#46; Complications of liver transplant are stenosis of biliary tract&#44; with an incidence of 5-25&#37;&#44; which influences both morbidity and mortality&#46;</p><p id="spara002" class="elsevierStyleSimplePara elsevierViewall">Nowadays&#44; treatment has evolved with Endoscopic Retrograde Cholangiopancreatography &#40;ERCP&#41;&#46; This treatment consists of dilation&#44; prothesis placement and stents&#46;</p><p id="spara003" class="elsevierStyleSimplePara elsevierViewall">The main objective of this study consists in describing the clinical characteristics&#44; therapeutic strategies&#44; results and impact in post-liver transplant patients with bile duct stenosis at the National Medical Center &#8220;20 de Noviembre&#8221;&#46;</p></span> <span id="abss0002" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cesectitle0002">Materials and Patients</span><p id="spara004" class="elsevierStyleSimplePara elsevierViewall">In this retrospective observational study&#44; a total of 39 post-liver transplant patients who presented bile duct stenosis complications were included&#44; receiving endoscopic treatment from 2018 to 2023 with ERCP at the National Medical Center &#8220;20 de Noviembre&#8221;&#46;</p></span> <span id="abss0003" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cesectitle0003">Results</span><p id="spara005" class="elsevierStyleSimplePara elsevierViewall">A total of 39 post-liver transplant patients with bile duct stenosis were included&#46; The mean age was 49&#46;8 years&#44; with equal distribution between genders&#46; The main causes of liver transplantation were autoimmune diseases &#40;41&#37;&#41; and alcohol-induced liver cirrhosis &#40;23&#37;&#41;&#46; The immunosuppressive treatment they received consisted of mycophenolate mofetil &#40;MMF&#41;&#44; tacrolimus&#44; and prednisone in 92&#37; of the cases&#46; Regarding endoscopic procedures&#44; a total of 163 ERCP were performed&#44; an average of 4 per patient with prosthesis placement in 64&#37;&#44; mainly plastic &#40;64&#37;&#41;&#46; Pneumatic dilation was the most used method &#40;64&#37;&#41;&#46; The complication related to endoscopic procedure was cholangitis in 17&#46;9&#37;&#44; without pancreatitis&#46; Bile duct rehabilitation was successful in 64&#37;&#46; Three patients presented death&#44; all related to graft rejection&#46;</p></span> <span id="abss0004" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cesectitle0004">Conclusions</span><p id="spara006" class="elsevierStyleSimplePara elsevierViewall">Bile duct stenosis is a significant complication in post-liver transplant patients&#44; which must be treated individually&#46; Bile duct rehabilitation was successful in more than half of the cases&#46; That said&#44; placement of prosthesis is the most effective strategy in these cases&#46; However&#44; additional research is required to identify success predictors and improve the management of post-transplant complications&#46;</p></span>"
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Original language: English
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