Abstract
Background
Small-caliber plastic stents are sometimes placed across the hepaticojejunostomy in liver transplant recipients at the time of biliary reconstruction. These stents usually pass spontaneously, but they can be retained and, rarely, this may cause biliary obstruction.
Objective
The purpose of this paper is twofold: to describe the appearance of biliary tract obstruction caused by retained surgical stents in pediatric liver transplants, and to report how these stents can be removed using interventional radiology techniques.
Materials and methods
Three pediatric patients presenting with biochemical and imaging evidence of biliary obstruction were encountered over a 6-month period. At percutaneous cholangiography all patients were found to have retained surgical stents which appeared to be causing biliary tract obstruction. Percutaneous snaring of the stents was undertaken.
Results
All stents were successfully removed using interventional radiology techniques, and follow-up showed no evidence of recurrent obstruction.
Conclusion
Surgical stents in children undergoing hepaticojejunostomy may be retained and cause biliary obstruction. Radiologists involved with imaging these patients should be aware of this potential cause of biliary obstruction. This complication is amenable to interventional radiology techniques with good long-term results. There is no easy endoscopic or surgical treatment option in these patients.
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References
Zajko AB, Bron KM, Campbell WL et al (1987) Percutaneous transhepatic cholangiography and biliary drainage after liver transplantation: a five-year experience. Gastrointest Radiol 12:137–143
Zajko AB, Campbell WL, Bron KM et al (1988) Diagnostic and interventional radiology in liver transplantation. Gastroenterol Clin North Am 17:105–143
Buck DG, Zajko AB (2008) Biliary complications after orthotopic liver transplantation. Tech Vasc Interv Radiol 11:51–59
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Crowley, J.J., Zajko, A.B., Fitz, C.R. et al. Retained surgical stents as a cause of biliary obstruction in pediatric liver transplants. Pediatr Radiol 45, 430–434 (2015). https://doi.org/10.1007/s00247-014-3144-4
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DOI: https://doi.org/10.1007/s00247-014-3144-4