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Biliary strictures in liver transplant recipients: treatment with metal stents
W C Culp1, T C McCowan, R P Lieberman
1Department of Radiology, University of Nebraska Medical Center, Omaha.
Purpose:
To determine initial and long-term results of metal stent placement in biliary strictures that failed to respond to balloon dilation.
Materials And Methods:
Sixty-one metal stents were placed in 36 liver transplant recipients (age range, 3 months to 71 years) with biliary strictures that failed to respond to balloon dilation. Patients were followed up for up to 5 years.
Results:
Initial stent placement was successful in all patients. Primary patency was 44% at 3 years and was 0% at 5 years; secondary patency was maintained at 88% at those intervals. Patency associated with the Gianturco Z stent was superior to that with the Palmaz stent. Stents located at anastomotic sites had higher patency rates than those at nonanastomotic sites. Major stent-related complications occurred in eight patients and included two pediatric deaths.
Conclusion:
Metal stents can be useful in the short term but have limited patency, often require repeat intervention, and have substantial complications. Long-term success depends heavily on repeat interventions or stent removal.