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Biliary cast syndrome:literature review and a single centre experience in liver transplant recipients 被引量:8
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作者 Narasimhaiah Srinivasaiah Mettu Srinivas Reddy +3 位作者 Schlok Balupuri David Talbot Bryon Jaques Derek Manas 《Hepatobiliary & Pancreatic Diseases International》 SCIE CAS 2008年第3期300-303,共4页
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 ... 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. 展开更多
关键词 liver transplantation biliary cast syndrome endoscopic retrograde cholangiopancreatography
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Biliary Cast Syndrome: Hepatic Artery Resistance Index, Pathological Changes, Morphology and Endoscopic Therapy 被引量:2
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作者 Hu Tian Qian-De Liao +3 位作者 Nian-Feng Li Jian Peng Lian-Sheng Gong Ju Liu 《Chinese Medical Journal》 SCIE CAS CSCD 2015年第14期1910-1915,共6页
Background: BiNary cast syndrome (BCS) was a postoperative complication of orthotopic liver transplantation (OLT), and the reason for BSC was considered to relate with ischemic type biliary lesions. This study ai... Background: BiNary cast syndrome (BCS) was a postoperative complication of orthotopic liver transplantation (OLT), and the reason for BSC was considered to relate with ischemic type biliary lesions. This study aimed to evaluate the relationship between BCS following OLT and the hepatic artery resistance index (HARt), and to observe pathological changes and morphology of biliary casts. Methods: Totally, 18 patients were diagnosed with BCS by cholangiography following OLT using choledochoscope or endoscopic retrograde cholangiopancreatography. In addition, 36 patients who did not present with BCS in the corresponding period had detectable postoperative HARI on weeks I, 2, 3 shown by color Doppler flow imaging. The compositions ofbiliary casts were analyzed by pathological examination and scanning electron microscopy. Results: HARI values of the BCS group were significantly decreased as compared with the non-BCS group on postoperative weeks 2 and 3 (P 〈 0.05). Odds ratio (OR) analysis of HARI 1, HARI 2, HARI 3 following the operation was 〉1 (OR = 1.300: 1.223 and 1.889, respectively). The OR of HARI 3 was statistically significant (OR - 1.889; 95% confidence interval - 1.166-7.490; P - 0.024). The compositions of biliary casts were different when bile duct stones wcrc present. Furthermore, vascular epithelial cells were found by pathological examination in binary casts. Conclusions: HARI may possibly serve as an independent risk factor and early predictive factor of BCS. Components and formation of binary casts and bile duct stones are different. 展开更多
关键词 biliary cast syndrome Endoscopic Therapy Hepatic Artery Resistance Index lschemic Type biliary Lesions: OrthotopicLiver Transplantation
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