Keyword: Percutaneous Transhepatic Cholangiography
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Original Article
Oncology, Nuclear Medicine and Transplantology, 2(1), 2026, onmt014, https://doi.org/10.63946/onmt/17741
ABSTRACT:
Abstract. Biliary strictures represent one of the most common complications after liver transplantation, occurring in 10-30% of recipients and significantly affecting patient quality of life and graft function. Combined hybrid approaches are increasingly widespread in contemporary practice.
Objective: To present a case series of successful application of combined methods for biliary stricture management in patients after liver transplantation and to analyze the efficacy and safety of these approaches.
Methods: A prospective observational study of three female patients (median age 57.0±7.8 years) after orthotopic liver transplantation with biliary strictures was conducted. All underwent a combined procedure using the rendezvous technique, integrating percutaneous transhepatic and endoscopic approaches with biliary stent placement.
Results: Technical success was achieved in 100% of cases (3/3). Clinical success with bilirubin reduction >50% was registered in all patients (3/3, 100%). Total bilirubin decreased from 71.3±22.8 μmol/L to 58.2±18.5 μmol/L by day 7 and to 32.4±8.6 μmol/L by day 30. No serious complications were registered (0/3, 0%). Mean hospitalization was 5.3±1.5 days (range 4-7 days). Mean procedure duration was 85±15 minutes.
Conclusion: The combined method demonstrated high technical feasibility (100%), clinical efficacy (100%), and a favorable safety profile with no serious complications, showing particular effectiveness in recurrent strictures. This approach can be considered as a promising alternative to isolated interventions in treating complex anastomotic biliary strictures.
Objective: To present a case series of successful application of combined methods for biliary stricture management in patients after liver transplantation and to analyze the efficacy and safety of these approaches.
Methods: A prospective observational study of three female patients (median age 57.0±7.8 years) after orthotopic liver transplantation with biliary strictures was conducted. All underwent a combined procedure using the rendezvous technique, integrating percutaneous transhepatic and endoscopic approaches with biliary stent placement.
Results: Technical success was achieved in 100% of cases (3/3). Clinical success with bilirubin reduction >50% was registered in all patients (3/3, 100%). Total bilirubin decreased from 71.3±22.8 μmol/L to 58.2±18.5 μmol/L by day 7 and to 32.4±8.6 μmol/L by day 30. No serious complications were registered (0/3, 0%). Mean hospitalization was 5.3±1.5 days (range 4-7 days). Mean procedure duration was 85±15 minutes.
Conclusion: The combined method demonstrated high technical feasibility (100%), clinical efficacy (100%), and a favorable safety profile with no serious complications, showing particular effectiveness in recurrent strictures. This approach can be considered as a promising alternative to isolated interventions in treating complex anastomotic biliary strictures.
