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| 1 | Diagnosis of biliary strictures after liver transplantation:Which is the best tool?显示文摘AIM: To evaluate the diagnostic value of different indirect methods like biochemical parameters, ultrasound (US) analysis, CT-scan and MRI/MRCP in comparison with endoscopic retrograde cholangiography (ERC), for diagnosis of biliary complications after liver transplantation. METHODS: In 75 patients after liver transplantation, who received ERC due to suspected biliary complications, the result of the cholangiography was compared to the results of indirect imaging methods performed prior to ERC. The cholangiography showed no biliary stenosis (NoST) in 25 patients, AST in 27 and ITBL in 23 patients. RESULTS: Biliary congestion as a result of AST was detected with a sensitivity of 68.4% in US analysis (specificity 91%), of 71% in MRI (specificity 25%) and of 40% in CT (specificity 57.1%). In ITBL, biliary congestion was detected with a sensitivity of 58.8% in the US, 88.9%in MRI and of 83.3% in CT. However, as anastomotic or ischemic stenoses were the underlying cause of biliary congestion, the sensitivity of detection was very low. InMRI detected the dominant stenosis at a correct localization in 22% and CT in 10%, while US failed completely. The biochemical parameters, showed no significant difference in bilirubin (median 5.7; 4,1; 2.5 mg/dL), alkaline phosphatase (median 360; 339; 527 U/L) or gamma glutamyl transferase (median 277; 220; 239 U/L) levels between NoST, AST and ITBL.CONCLUSION: Our data confirm that indirect imaging methods to date cannot replace direct cholangiography for diagnosis of post transplant biliary stenoses. However MRI may have the potential to complement or precede imaging by cholangiography. Optimized MRCP-processing might further improve the diagnostic impact of this method. | Thomas Zoepf Evelyn J. Maldonado-Lopez Philip Hilgard Alexander Dech■ne Massimo Malago Christoph E. Broelsch Joerg Schlaak Guido Gerken | 2005 | World Journal of Gastroenterology2005，11，19： | 32 |
| 2 | Successful photodynamic therapy for biliary papillomatosis:A case report显示文摘Papillomatosis of the bile duct is a rare disease with a high risk of malignant transformation. Therapeutical options include partial hepatectomy and liver transplantation. A previously healthy 65-years old male developed jaundice and right upper abdominal quadrant pain in 1996. A villous adenoma of the distal bile duct was diagnosed. A Whipple procedure was performed. In 2002 the patient turned symptomatic again. Another adenoma was found in the right hepatic duct resulting in a right hepatectomy. Two years later the patient again developed cholestasis. After drainage of the left hepatic duct with a percutaneous transhepatic cholangial drainage (PTCD) catheter, a recurrent biliary adenomatosis was diagnosed by cholangioscopy. As there was no surgical option left, the patient received photodynamic therapy (PDT) for the recurrent biliary papillomatosis. Three mo after he received further photodynamic therapies, the bile duct epithelium appeared normal and the patient had no signs of adenomatosis, both macroscopically and histologically. The follow-up cholangioscopy in late 2005 revealed only a small papilloma without the need for intervention. In early 2006, the patient died of multi organ failure without signs of extrahepatic cholestasis or cholangitis at the age of 75, 10 years after the diagnosis of biliary papillomatosis was established. The patient exceeded the average life expectancy of patients with biliary papillomatosis by far. Thus, PDT might be a sufficient therapeutic option for recurrent papillomatosis patients with no significant side effects. | Lars P Bechmann Philip Hilgard Andrea Frilling Brigitte Schumacher Hideo A Baba Guido Gerken Thomas Zoepf | 2008 | World Journal of Gastroenterology2008，14，26： | 7 |
| 3 | Optimized endoscopic treatment of ischemic-type biliary lesions after liver transplantation显示文摘 | Thomas Zoepf Evelyn J. Maldonado de Dechêne Alexander Dechêne Massimo Malágo Susanne Beckebaum Andreas Paul Guido Gerken Philip Hilgard | 2012 | Gastrointestinal Endoscopy2012，，3： | 2 |
| 4 | Endoscopic Therapy of Posttransplant Biliary Stenoses After Right-Sided Adult Living Donor Liver Transplantation显示文摘 | Thomas Zoepf Evelyn J. Maldonado–lopez Philip Hilgard Joerg Schlaak Massimo Malago Christoph E. Broelsch Ulrich Treichel Guido Gerken | 2005 | Clinical Gastroenterology and Hepatology2005，，11： | 1 |
| 5 | Balloon dilatation vs. balloon dilatation plus bile duct endoprostheses for treatment of anastomotic biliary strictures after liver transplantation显示文摘 | Thomas Zoepf Evelyn J. Maldonado‐Lopez Philip Hilgard Massimo Malago Christoph E. Broelsch Ulrich Treichel Guido Gerken | 2005 | Liver Transpl2005，，1： | 1 |
| 6 | Survival Difference in Patients with Photodynamic Therapy of Nonresectable Bile Duct Cancer Using Different Hematoporphyrins显示文摘 | Alexander Dechene Philip Hilgard Evelyn J. Maldonado-Lopez Juergen F. Riemann Guido Gerken Thomas Zoepf | 2007 | Gastrointestinal Endoscopy2007，，5： | 1 |
| 7 | Optimized endoscopic treatment of ischemic-type biliary lesions after liver transplantation显示文摘 | Thomas Zoepf Evelyn J. Maldonado de Dechêne Alexander Dechêne Massimo Malágo Susanne Beckebaum Andreas Paul Guido Gerken Philip Hilgard | 2012 | Gastrointestinal Endoscopy2012，，3： | 1 |
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