Radiologia · 2026
Percutaneous treatment of biliary strictures following paediatric liver transplantation: Safety and efficacy of the single-session biliary dilatation protocol.
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Perez Montilla M E, Lombardo Galera M S, García Jurado P B, Barranco Acosta S, Espejo Herrero J J
Аннотация
OBJECTIVE: This work aims to evaluate the safety and efficacy of percutaneous balloon dilatation (BD) carried out in a single session to treat biliary strictures/obstructions after paediatric liver transplantation (LT).
MATERIAL AND METHODS: This retrospective single-centre study enrolled 20 paediatric patients (<18 years) with biliary strictures/obstructions following a LT carried out between 2013 and 2023. The treatment consisted of a percutaneous transhepatic cholangiography and BD during a single session (no external/internal catheter was left). Data was collected regarding demographics, clinical information, procedural details and any complications. Clinical and radiological follow-ups assessed clinical efficacy and recurrence. All cases of recurrence underwent percutaneous treatment. Recurrence risk factors were evaluated. The primary and secondary patency rates were determined at 6, 12, 24, and 62 months.
RESULTS: 17 patients (mean age, 5 years) with anastomotic (13/76.5%) and non-anastomotic (4/23.5%) biliary stricture were treated. Two patients had complications (11.8%). Mean follow-up time was 7.3 years. Clinical success was 82.3% (14/17). In five children (29.4%) the single-session BD resolved the biliary stricture. The stricture recurred in 12 patients (70.6%). The recurrence rate was 69.2% for anastomotic strictures and 75% for non-anastomotic strictures (p = 0.670). Recurrences were treated percutaneously (18 s treatments): BD (13) and biliary stent (5). Surgery was avoided in 94.1% of patients. Primary patency rates at 6, 12, 24, 62 months were 76.5%, 51%, 38.2% and 25.5%, respectively. Secondary patency rates at 6, 12, 24, 62 months were 100%, 100%, 88.9% and 88.9%, respectively.
CONCLUSIONS: Single-session percutaneous BD is an effective treatment for biliary stricture/obstruction after paediatric LT, often preventing the need for surgery or retransplantation.
MATERIAL AND METHODS: This retrospective single-centre study enrolled 20 paediatric patients (<18 years) with biliary strictures/obstructions following a LT carried out between 2013 and 2023. The treatment consisted of a percutaneous transhepatic cholangiography and BD during a single session (no external/internal catheter was left). Data was collected regarding demographics, clinical information, procedural details and any complications. Clinical and radiological follow-ups assessed clinical efficacy and recurrence. All cases of recurrence underwent percutaneous treatment. Recurrence risk factors were evaluated. The primary and secondary patency rates were determined at 6, 12, 24, and 62 months.
RESULTS: 17 patients (mean age, 5 years) with anastomotic (13/76.5%) and non-anastomotic (4/23.5%) biliary stricture were treated. Two patients had complications (11.8%). Mean follow-up time was 7.3 years. Clinical success was 82.3% (14/17). In five children (29.4%) the single-session BD resolved the biliary stricture. The stricture recurred in 12 patients (70.6%). The recurrence rate was 69.2% for anastomotic strictures and 75% for non-anastomotic strictures (p = 0.670). Recurrences were treated percutaneously (18 s treatments): BD (13) and biliary stent (5). Surgery was avoided in 94.1% of patients. Primary patency rates at 6, 12, 24, 62 months were 76.5%, 51%, 38.2% and 25.5%, respectively. Secondary patency rates at 6, 12, 24, 62 months were 100%, 100%, 88.9% and 88.9%, respectively.
CONCLUSIONS: Single-session percutaneous BD is an effective treatment for biliary stricture/obstruction after paediatric LT, often preventing the need for surgery or retransplantation.