Post-transplant biliyer darlığın tedavisinde manyetik kompresyon yöntemi: Olgu sunumu

Öz

Cerrahi tekniklerdeki gelişmelere rağmen biliyer komplikasyonlar hala yaygındır ve karaciğer nakli sonrasında hasta sağkalımını etkilemektedir. Biliyer darlıklar, genellikle endoskopik retrograd kolanjiyopankreatografi ve perkütan transhepatik kolanjiyografi ile tedavi edilmektedir. Bununla birlikte, biliyer anastomozun tam darlığı durumlarında, cerrahi yeniden anastomoz bir tedavi seçeneğidir. Ancak yeniden anastomoz için cerrahi prosedürler invazivdir ve postoperatif adezyon ve hastaların genel durumu nedeniyle uygulanması zordur. Manyetik kompresyon yöntemi, endoskopik retrograd kolanjiyopankreatografi ve perkütan transhepatik kolanjiyografi ile tedavi edilemeyen olgularda, cerrahi gerektirmeyen güvenli bir anastomoz yöntemidir. Burada, canlı donör karaciğer transplantasyonundan sonra manyetik kompresyon yöntemi ile başarılı şekilde tedavi edilen bir olguyu sunuyoruz.

Anahtar Kelimeler

• Karaciğer transplantasyonu
• biliobiliyer anastomoz darlığı
• manyetik kompresyon anastomozu

Magnetic compression method in the treatment of post-transplant biliary stricture: A case report

Öz

Despite advances in surgical techniques, biliary complications are still common and affect patient survival after liver transplantation. Biliary strictures are usually treated with endoscopic retrograde cholangiopancreatography and percutaneous transhepatic cholangiography. However, in cases of complete stenosis of the biliary anastomosis, surgical re-anastomosis is a treatment option. However, surgical procedures for re-anastomosis are invasive and difficult to perform due to postoperative adhesion and the general condition of the patients. Magnetic compression method is a safe anastomosis method that does not require surgery in cases that cannot be treated with endoscopic retrograde cholangiopancreatography and percutaneous transhepatic cholangiography. Here, we present a case successfully treated with magnetic compression method after living donor liver transplantation.

Anahtar Kelimeler

• Liver transplantation
• biliobiliary anastomosis stenosis
• magnetic compression anastomosis

Kaynakça

1. 1. Tung BY, Kimmey MB. Biliary complications of orthotopic liver transplantation. Dig Dis 1999;17:133-44.
2. 2. Chang JH, Lee IS, Choi JY, et al. Biliary stricture after adult right-lobe living-donor liver transplantation with duct-to-duct anastomosis: long-term outcome and its related factors after endoscopic treatment. Gut Liver 2010;4:226-33.
3. 3. Ryu CH, Lee SK. Biliary strictures after liver transplantation. Gut Liver 2011;5:133-42.
4. 4. Schwartz DA, Petersen BT, Poterucha JJ, Gostout CJ. Endoscopic therapy of anastomotic bile duct strictures occurring after liver transplantation. Gastrointest Endosc 2000;51:169-74.
5. 5. Sharma S, Gurakar A, Jabbour N. Biliary strictures following liver transplantation: past, present and preventive strategies. Liver Transpl 2008;14:759-69.
6. 6. Jang SI, Kim JH, Won JY, et al. Magnetic compression anastomosis is useful in biliary anastomotic strictures after living donor liver transplantation. Gastrointest Endosc 2011;74:1040-8.
7. 7. Jang SI, Cho JH, Lee DK. Magnetic Compression Anastomosis for the Treatment of Post-Transplant Biliary Stricture. Clin Endosc 2020;53:266-75.