Biliary strictures after liver transplantation. Predictive factors for response to endoscopic management and long-term outcome

Jose Barriga, R. O.Y. Thompson, Hosein Shokouh-Amiri, Rena Davila, Mohammad K. Ismail, Bradford Waters, Claudio R. Tombazzi

Research output: Contribution to journalArticlepeer-review

20 Scopus citations


Background: Biliary strictures after liver transplantation are frequent. The long-term prognosis and predictive factors of response to endoscopic treatment are not well known. Methods: The aim of this study was to demonstrate the role of endoscopic treatment, predictive factors of response, and outcome in patients with biliary stricture after liver transplantation. We performed a retrospective review of medical records of all consecutive post-liver transplantation patients who underwent endoscopic retrograde cholangiography in our center during the period from October 2001 to October 2006. Results: Twenty-five of 43 patients referred for endoscopic retrograde cholangiography had biliary stricture. Eighteen had stricture at the area of the anastomosis alone, 2 patients had a stricture at the area of the anastomosis and also another area, and 5 had nonanastomotic biliary strictures. Twenty-one patients had a single stricture and 4 had more than 1 stricture. Initially 19 of 24 patients (79%) responded to endoscopic management with normalization of liver enzymes. Four patients (16%) did not respond clinically despite a successful endoscopic approach. All patients who did not respond to endoscopic dilation had more than 1 area of stricture. There was a significantly better response to endoscopic treatment in patients with an anastomotic stricture versus patients with nonanastomotic strictures 17/19 versus 2/5 (P = 0.042). Conclusions: In our experience, endoscopic treatment of anastomotic biliary strictures is highly effective with a good long-term outcome. The presence of nonanastomotic and multiple strictures should be considered a factor associated with poor response to endoscopic management.

Original languageEnglish
Pages (from-to)439-443
Number of pages5
JournalAmerican Journal of the Medical Sciences
Issue number6
StatePublished - Jun 2008


  • Biliary strictures
  • Endoscopic treatment
  • Liver transplantation


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