Biliary cast syndrome:literature review and a single centre experience in liver transplant recipients

BACKGROUND:Biliary cast syndrome(BCS)is an unusual complication of orthotopic liver transplantation (OLTx),and its management is difficult.Limited success using endoscopic retrograde cholangiopancreatography (ERCP)or open exploration to clear casts has been reported, but failure usually results in re-transplantation.We aimed to review our experience with BCS and highlight a novel combined percutaneous and endoscopic approach for duct clearance.A brief review of the literature is given. METHODS:We retrospectively reviewed our experience of managing BCS using case notes review.Details were also gathered from radiology,where interventional procedures were carried out. RESULTS:We had a total of three cases of BCS reported between 2002 and 2005.Multiple attempts were made to remove these casts.All three were treated in a variety of ways.Management is discussed along with highlighting a novel combined percutaneous and endoscopic approach for duct clearance. CONCLUSIONS:BCS is a potential complication of OLTx. Surgical and endoscopic methods of removing casts are used.However,in circumstances where these methods are technically difficult,a percutaneous endoscopic approach with serial dilatation of the cutaneous port and surgical removal of casts can be done.

每个孩子一台手提电脑?

"每个孩子一台手提电脑"(One Laptop per Child,简称OLPC)是个旨在通过提供廉价笔记本电脑,帮助发展中国家儿童享受信息化时代教育的慈善计划。在秘鲁,超过48万台手提电脑正被送往世界最穷困的地方,为部分全球受教育水平最低的孩子带来全新的学习体验。