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| 1 | Management of liver transplantation biliary stricture: Results from a tertiary hospital显示文摘AIM: To review results of endoscopic treatment for anastomotic biliary strictures after orthotopic liver transplantation(OLT) during an 8-year period. METHODS: This is a retrospective review of all endoscopic retrograde cholangiopancreatographys(ERCPs) performed between May 2006 and June 2014 in deceased OLT recipients with anastomotic stricture at a tertiary care hospital. Patients were divided into 2 groups, according to the type of stent used(multiple plastic or covered self-expandable metal stents), which was chose on a case-by-case basis and their characteristics. The primary outcome was anastomotic stricture resolution rate determined if there was no more than a minimum waist at cholangiography and a 10 mm balloon could easily pass through the anastomosis with no need for further intervention after final stent removal. Secondary outcomes were technical successrate, number or ERCPs required per patient, number of stents placed, stent indwelling, stricture recurrence rate and therapy for recurrent anastomotic biliary stricture(AS). Stricture recurrence was defined as clinical laboratorial and/or imaging evidence of obstruction at the anastomosis level, after it was considered completely treated, requiring subsequent interventional procedure.RESULTS: A total of 195 post-OLT patients were assessed for eligibility. One hundred and sixty-four(164) patients were diagnosed with anastomotic biliary stricture. ERCP was successfully performed in 157/164(95.7%) patients with AS, that were treated with either multiple plastic(n = 109) or metallic billiary stents(n = 48). Mean treatment duration, number of procedures and stents required were lower in the metal stent group. Acute pancreatitis was the most common procedure related complication, occurring in 17.1% in the covered self-expandable metal stents(c SEMS) and 4.1% in the multiple plastic stent(MPS) group. Migration was the most frequent stent related complication, observed in 4.3% and 5.5%(c SEMS and MPS respectively). Stricture resolution was achieved in 86.8% in the c SEMS group and in 91% in MPS group. Stricture recurrence after a median follow up of 20 mo was observed in 10(30.3%) patients in the c SEMS and 7(7.7%) in the plastic stent group, a statistically significant difference(P = 0.0017). Successful stricture resolution after secondary treatment was achieved in 66.6% and 62.5% of patients respectively in the c SEMS and plastic stents groups. CONCLUSION: Multiple plastic stents are currently the first treatment option for AS in patients with duct-toduct anastomosis. c SEMS was associated with increased pancreatitis risk and higher recurrence rate. | Fernanda Prata Martins Michel Kahaleh Angelo P Ferrari | 2015 | World Journal of Gastrointestinal Endoscopy2015，7，7： | 10 |
| 2 | 覆膜金属胆管支架在良性胆管狭窄中的应用显示文摘自膨式金属支架(self-expandable metal stent,SEMS)通常用于缓解恶性胆管狭窄。近来,覆膜自膨式金属支架(covered self-expandable metal stent,CSEMS)应用于良性胆管狭窄(benign biliary strictures,BBS),有延长支架通畅时间、减少内镜操作次数等优点,但是也可导致胆囊炎、支架移位、胰腺炎等并发症。因此,在精心选择的BBS病例中,可选用合适的CSEMS。这一综述主要着眼于CSEMS在BBS中的应用。 | 钱晶瑶 李文 | 2014 | 胃肠病学和肝病学杂志2014，23，4： | 1 |
| 3 | Risk factors affecting the Barrett'smetaplasia-dysplasia-neoplasia sequence显示文摘Biliary complications are being increasingly encounteredin post liver transplant patients because ofincreased volume of transplants and longer survivalof these recipients. Overall management of thesecomplications may be challenging, but with advancesin endoscopic techniques, majority of such patientsare being dealt with by endoscopists rather than thesurgeons. Our review article discusses the recent advancesin endoscopic tools and techniques that haveproved endoscopic retrograde cholangiography withvarious interventions, like sphincterotomy, bile ductdilatation, and stent placement, to be the mainstay formanagement of most of these complications. We alsodiscuss the management dilemmas in patients withsurgically altered anatomy, where accessing the bile ductis challenging, and the recent strides towards makingthis prospect a reality. | | 2015 | World Journal of Gastrointestinal Endoscopy2015，7，5： | 0 |
| 4 | 对胆管支撑引流管价值的再认识显示文摘以往,胆管切开后放置支撑引流管在肝胆外科手术中是一种共识。然而,随着胆道生理研究与外科技术的发展,特别是快速康复医学理念的兴起,胆管支撑引流管带来的负面效应逐渐得到人们的重视。胆管切开后是否应该放置支撑引流管目前仍无确切定论。 | 王晓波 罗丁 | 2012 | 国际外科学杂志2012，39，5： | 0 |
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