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A case of biliary stones and anastomotic biliary stricture after liver transplant treated with the rendez-vous technique and electrokinetic lithotritor
Authors:Di Pisa Marta  Traina Mario  Miraglia Roberto  Maruzzelli Luigi  Volpes Riccardo  Piazza Salvatore  Luca Angelo  Gridelli Bruno
Affiliation:1. Department of Gastroenterology,IsMeTT, UPMC, Via Tricomi, Palermo 90100, Italy
2. Department of Radiology,IsMeTT, UPMC, Via Tricomi 1, Palermo 90100, Italy
3. Department of Hepatology, IsMeTT, UPMC,Palermo 90100, Italy
4. Civico Hospital, Via Tricomi, Palermo 90100,Italy
5. Department of Radiology, IsMeTT, UPMC,Palermo 90100, Italy
6. Department of Surgery, IsMeTT, UPMC, Palermo 90100, Italy
Abstract:The paper studies the combined radiologic and endoscopic approach (rendezvous technique) to the treatment of the biliary complications following liver transplant. The "rendez-vous" technique was used with an electrokinetic lithotripter, in the treatment of a biliary anastomotic stricture with multiple biliary stones in a patient who underwent orthotopic liver transplant. In this patient, endoscopic or percutaneous transhepatic management of the biliary complication failed. The combined approach, percutaneous transhepatic and endoscopic treatment (rendez-vous technique) with the use of an electrokinetic lithotritor, was used to solve the biliary stenosis and to remove the stones.Technical success, defined as disappearance of the biliary stenosis and stone removal, was obtained in just one session, which definitively solved the complications.The combined approach of percutaneous transhepatic and endoscopic (rendez-vous technique) treatment, in association with an electrokinetic lithotritor, is a safe and feasible alternative treatment, especially after the failure of endoscopic and/or percutaneous trans-hepatic isolated procedures.
Keywords:Biliary complications  Liver transplant  Endoscopic retrograde cholangiopancreatography  Percutaneous Transhepatic Cholangiography,Percutaneous lithotripsy
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