Endoscopic treatment of biliary strictures after liver transplantation: balloon dilatation with stenting improves...

Endoscopic treatment is the standard treatment for biliary strictures after liver transplantation (LT), but the specific strategies and different success patterns have not been clearly defined in terms of their impact on survival. The aim of this study was to investigate the predictors of successful endoscopic treatment and the impact of different patterns of success on patient survival outcomes. A total of 93 patients with accurately diagnosed biliary strictures who subsequently underwent endoscopic retrograde cholangiopancreatography (ERCP) were retrospectively enrolled. The primary endpoint was standard of care success and final treatment success, while secondary endpoint was overall survival. Non-anastomotic strictures (NAS) and anastomotic strictures (AS) were diagnosed in 57 and 36 patients, respectively, based on imaging before the last ERCP procedure. Definitive treatment success was achieved significantly more often in patients with AS (P = 0.018), while there was no significant difference in standard treatment success between AS and NAS (P = 0.900). Both treatment success patterns showed a better overall survival benefit in the overall and NAS groups (P < 0.05), and in the AS group, the survival curve showed a long-term benefit for both treatment success patterns, despite no statistical difference. In addition, balloon dilatation with stenting increased final treatment success in the overall groups. ERCP is a safe and effective therapeutic option for patients with NAS and AS, with both successful treatment patterns improving long-term survival. Balloon dilatation with stenting can increase the treatment success of ERCP in both types of biliary strictures.