Preliminary safety and efficacy of laser stricturotomy for treatment of refractory biliary anastomotic strictures following liver transplantation

Am J Transplant. 2023 Apr;23(4):573-576. doi: 10.1016/j.ajt.2022.12.020. Epub 2023 Jan 4.


Biliary anastomotic stricture (BAS) is a frequent complication of liver transplantation and is associated with reduced graft survival and patient morbidity. Existing treatments for BAS involve dilation of the stricture though placement of 1 or more catheters for 6 to 24 months yielding limited effectiveness in transplant patients. In this case series, we present preliminary safety and efficacy of a novel percutaneous laser stricturotomy treatment in a cohort of 5 posttransplant patients with BAS refractory to long-term large bore catheterization. In all patients, holmium or thulium laser was used to excise the stricture and promote biliary re-epithelization. There were no periprocedural complications. Technical success was 100% and at mean follow-up time of 22 months, there have been no recurrences. In conclusion, percutaneous laser stricturotomy demonstrates preliminary safety and efficacy in treatment of refractory BAS following liver transplantation.

Keywords: benign anastomotic stricture; clinical research/practice; liver allograft function/dysfunction; liver transplantation/hepatology.

Publication types

  • Case Reports

MeSH terms

  • Catheterization / adverse effects
  • Cholestasis* / etiology
  • Cholestasis* / surgery
  • Constriction, Pathologic / etiology
  • Constriction, Pathologic / surgery
  • Humans
  • Liver Transplantation* / adverse effects
  • Retrospective Studies
  • Treatment Outcome