Thursday, March 13, 2014

Second follow up ERCP for post transplant anastomotic biliary stricture (CASE D)

This 40 year old gentleman had undergone a living donor liver transplant in June 2013 at our centre. He had developed repeated episodes of fever and right hypochondrial pain along with rising bilirubin in December. He was diagnosed with an anastomotic biliary stricture (A: red arrow) . He then traveled abroad and underwent ERCP with placement of a plastic biliary stent of 7 French diameter and 12 cm length. Over the past two weeks, his bilirubin levels had increased and he had been having recurrence of his hypochondrial pain. We suspected a blocked stent. This was confirmed visually and the stent was removed (B1 & B2). Contrast injection outlined the stricture (C: red arrow). A 3cm TTS balloon of 10mm diameter was maneuvered to the stricture (D: black arrows) and inflated (E: white arrow shows the waist of the balloon during inflation). A 12 cm long 10 French plastic stent was placed (F: white arrows).

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Second (actually 3rd) ERCP for post transplant biliary leak

This 60 year old gentleman had earlier undergone ERCP and stenting for an anastomotic biliary leakage a few months earlier http://ercp365.bl...