Mo1934 MRCP is Associated With High Sensitivity and Ppv in Diagnosing Bile Duct Strictures in Patients Following Liver Transplantation as Compared to Direct Cholangiography

Abstract

A S L D A b st ra ct s patients with EAS were successfully managed with endoscopic intervention, compared to 16 of 20 (80%) patients with LAS. For those successfully managed endoscopically, the time to stricture resolution was 109.91 +/-24.37 for EAS versus 293.5+/-61.13 (p=0.025) for LAS. This equated to a median of 2.5+/-3 versus 4+/-9 ERCPs respectively (p=0.0001). When baseline characteristics including known risk factors for stricturing were compared (sex, age, living versus deceased donors, need for redo operation, donor or recipient CMV status, presence of biliary sludge or stones, requirement for dilatation and ERCP complications rates), only serum bilirubin at time of stricture demonstrated a significant difference (138.17+/-46.22 versus 36.12+/-8.26, p=0.002). Conclusions: Early anastomotic biliary strictures following liver transplantation can be successfully managed endoscopically, and require a shorter treatment interval with fewer ERCPs when compared to late anastomotic strictures. Early strictures are associated with a higher serum bilirubin at diagnosis. No other patient characteristics appear to be predictive for development of either stricture type.