Komatsu Naohiro, Ozawa Eisuke, Fukushima Masanori, Sawase Hironori, Nagata Kazuyoshi, Miuma Satoshi, Miyaaki Hisamitsu, Soyama Akihiko, Hidaka Masaaki, Eguchi Susumu, Nakao Kazuhiko
Department of Gastroenterology and Hepatology Nagasaki University Graduate School of Biomedical Sciences Nagasaki Japan.
Department of Surgery Nagasaki University Graduate School of Biomedical Sciences Nagasaki Japan.
DEN Open. 2023 Mar 27;3(1):e225. doi: 10.1002/deo2.225. eCollection 2023 Apr.
Anastomotic biliary strictures (ABSs) are common complications following living donor liver transplantation (LDLT). We evaluated the feasibility of a novel removable, intraductal, fully covered, self-expandable metallic stent (FCSEMS) for the treatment of ABSs following LDLT.
Nine patients with duct-to-duct ABSs that developed following LDLT were prospectively enrolled in this study. We placed a short FCSEMS with a long lasso and middle waist formation in each patient's ABS above the papilla and removed it 16 weeks later.
The FCSEMS placements were successful in all nine cases. Four patients experienced mild cholangitis, which was resolved with conservative treatment. Additionally, there was one case of distal migration. The FCSEMSs were successfully removed from all the patients, and the clinical success rate was 100%. Stricture recurrence occurred in one (11.1%) patient during the follow-up period.
The small number and lack of comparison with other types of FCSEMSs and plastic stents.
Intraductal placement of FCSEMSs is useful for treating refractory ABSs after LDLT, although further studies are required with larger sample sizes.
吻合口胆管狭窄（ABS）是活体肝移植（LDLT）后常见的并发症。我们评估了一种新型可取出的、导管内、全覆膜、自膨式金属支架（FCSEMS）治疗LDLT术后ABS的可行性。
前瞻性纳入9例LDLT术后发生的端端吻合口ABS患者。我们在每位患者乳头上方的ABS处放置一个带有长套索和中间腰部结构的短FCSEMS，并在16周后取出。
9例患者FCSEMS放置均成功。4例患者发生轻度胆管炎，经保守治疗后缓解。此外，有1例发生远端移位。所有患者的FCSEMS均成功取出，临床成功率为100%。随访期间1例（11.1%）患者出现狭窄复发。
样本量小，且未与其他类型的FCSEMS和塑料支架进行比较。
FCSEMS导管内放置对治疗LDLT术后难治性ABS有用，尽管需要更大样本量的进一步研究。
