Case Report
Copyright ©2008 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. May 14, 2008; 14(18): 2920-2923
Published online May 14, 2008. doi: 10.3748/wjg.14.2920
A case of biliary stones and anastomotic biliary stricture after liver transplant treated with the rendez - vous technique and electrokinetic lithotritor
Marta Di Pisa, Mario Traina, Roberto Miraglia, Luigi Maruzzelli, Riccardo Volpes, Salvatore Piazza, Angelo Luca, Bruno Gridelli
Marta Di Pisa, Mario Traina, Department of Gastroenterology, IsMeTT, UPMC, Via Tricomi, Palermo 90100, Italy
Roberto Miraglia, Luigi Maruzzelli, Department of Radiology, IsMeTT, UPMC, Via Tricomi 1, Palermo 90100, Italy
Riccardo Volpes, Department of Hepatology, IsMeTT, UPMC, Palermo 90100, Italy
Salvatore Piazza, Civico Hospital, Via Tricomi, Palermo 90100, Italy
Angelo Luca, Department of Radiology, IsMeTT, UPMC, Palermo 90100, Italy
Bruno Gridelli, Department of Surgery, IsMeTT, UPMC, Palermo 90100, Italy
Author contributions: Di Pisa M and Traina M designed the work; Di Pisa M wrote the paper with a contribution from Volpes R and Miraglia R; The rest of the authors contributed equally to this work.
Correspondence to: Marta Di Pisa, Dr, IsMeTT, UPMC, Via Tricomi 1, Palermo 90100, Italy. mdipisa@ismett.edu
Telephone: +39-91-2192111
Fax: +39-91-2192400
Received: January 17, 2008
Revised: March 19, 2008
Published online: May 14, 2008
Abstract

The paper studies the combined radiologic and endoscopic approach (rendez vous 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