The New Rendezvous Techniques with KPM Catheter for Treatment of Biliary Stricture after Right-lobe Living Donor Liver Transplantation: Feasibility Study

Abstract

Purpose: Endoscopic treatment is the first choice in the biliary stricture after right-lobe living donor liver transplantation (LDLT) but has a risk of failure. The rendezvous technique is alternative and useful modality to insert stent inside the stricture. We studied the feasibility and safeness of the new rendezvous method with 5 Fr KPM catheter. Methods: Patients with biliary stricture after LDLT were underwent percutaneous transhepatic biliary drainage (PTBD) and then changed to 5Fr KPM catheter for rendezvous ERBD insertion. All patients were send to ERCP room for insertion of internal stent. We retrospectively analysed the medical record. The primary endpoint were procedure time and success rate and compared usefulness of KPM catheter rendezvous technique to previous reported data. Results: Twelve patients were included in this study from April to December, 2010. Median procedure time was 14 min (range 5-55) and more faster than guidewire rendezvous technique (median 29.4 min, 7.5-76.7)(P = 0.007). All procedures were successful. The number of internal stent was one in 10 patients and two in 2 patients. Mean diameter of internal stent was 9.8 Fr. All procedure were under the duodenoscope. There was no significant procedure related complication. Conclusion: Rendezvous technique with KPM PTBD catheter was safe and faster than previous technique. We suggest this technique as a one of alternative modality for a patients who are failed of initial endoscopic intervention.