TRANSHEPATIC BALLOON DILATION OF BILIARY STRICTURES IN LIVER-TRANSPLANT PATIENTS - A 10-YEAR EXPERIENCE

PURPOSE: The authors report their initial and long-term results using transhepatic balloon dilation to treat biliary strictures in liver transplant patients. PATIENTS AND METHODS: Over a 10-year period, 72 liver transplant patients with biliary strictures underwent 81 balloon dilation treatments. Anastomotic strictures were present in 56 patients; non-anastomotic strictures were present in 16. RESULTS: Initial technical success was achieved in 64 of 72 patients (89%). Balloon dilation failed in eight patients (11%) and they were treated surgically. Complications occurred in nine (12%) patients, and all were successfully treated. Within the first 6 months, five patients, (6.9%) required surgical revision. Three patients (4.2%) underwent repeated liver transplantation; and five patients (6.9%) died. Fifty-one patients in whom balloon dilation was initially successful were available for at least a 6-month follow-up. Life-table analysis showed an overall 81% +/- 4.8 success rate at 6 months; it dropped to 70% +/- 6.2 at 6 years. For anastomotic strictures, it was 77% +/- 5.8 at 6 months and 66% +/- 7.3 at 6 years. For nonanastomotic strictures, it was 94% +/- 6.2 at 6 months, which dropped to 84% +/- 10 at 5 years. CONCLUSION: Transhepatic balloon dilation represents an effective and relatively safe treatment for biliary stricture in liver transplant recipients.