{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T14:10:54Z","timestamp":1776867054636,"version":"3.51.2"},"reference-count":21,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2024,10,8]],"date-time":"2024-10-08T00:00:00Z","timestamp":1728345600000},"content-version":"vor","delay-in-days":7,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["JGH Open"],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Aims<\/jats:title><jats:p>Strictures are the most common biliary complication after liver transplantation, and endoscopic retrograde cholangiopancreatography (ERCP) is considered the gold standard in its management. Failure to cross the biliary anastomosis requires a repeated attempt with ERCP, referral for percutaneous transhepatic cholangiography (PTC) or surgery. We present our experience with the digital single operator cholangioscope (D\u2010SOC) in achieving guidewire access in a liver transplant cohort with difficult biliary strictures who have failed conventional ERCP methods.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a retrospective study involving two adult liver transplant centers servicing the two most populated states in Australia. Deceased\u2010donor liver transplant recipients undergoing D\u2010SOC for biliary strictures who have failed conventional methods to achieve biliary access were included.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Between July 2017 to April 2022, eighteen patients underwent D\u2010SOC after failing to achieve guidewire placement through standard ERCP techniques. Thirteen out of eighteen (72%) had successful guidewire placement with index D\u2010SOC. Five of eighteen patients (28%) had unsuccessful guidewire placement with D\u2010SOC. In two of these patients, use of D\u2010SOC informed further endoscopic management, with one avoiding PTC and the other avoiding surgery. Two of the five patients required PTC and one patient was left unstented. Three patients developed post D\u2010SOC cholangitis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>D\u2010SOC is effective at achieving guidewire access in post\u2010liver transplant patients who fail conventional ERCP techniques and should be considered in the treatment algorithm as a step before PTC and surgery.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jgh3.13112","type":"journal-article","created":{"date-parts":[[2024,10,9]],"date-time":"2024-10-09T06:49:47Z","timestamp":1728456587000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Evaluating the yield of digital single operator cholangioscopy in posttransplant biliary strictures after unsuccessful guidewire placement with <scp>ERCP<\/scp>"],"prefix":"10.1002","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1316-6662","authenticated-orcid":false,"given":"Jonathan","family":"Ng","sequence":"first","affiliation":[{"name":"Department of Gastroenterology and Hepatology Austin Health  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sujievvan","family":"Chandran","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Austin Health  Melbourne Victoria Australia"},{"name":"Faculty of Medicine, Dentistry and Health Sciences University of Melbourne  Melbourne Victoria Australia"},{"name":"Faculty of Medicine, Nursing and Health Sciences Monash University  Clayton Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0792-3265","authenticated-orcid":false,"given":"Kim Hay","family":"Be","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Austin Health  Melbourne Victoria Australia"},{"name":"Faculty of Medicine, Dentistry and Health Sciences University of Melbourne  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leonardo","family":"Zorron Cheng Tao Pu","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Austin Health  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kevin Kyung Ho","family":"Choi","sequence":"additional","affiliation":[{"name":"AW Morrow Gastroenterology and Liver Centre Royal Prince Alfred Hospital  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Payal","family":"Saxena","sequence":"additional","affiliation":[{"name":"AW Morrow Gastroenterology and Liver Centre Royal Prince Alfred Hospital  Sydney New South Wales Australia"},{"name":"Sydney Medical School University of Sydney  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arthur John","family":"Kaffes","sequence":"additional","affiliation":[{"name":"AW Morrow Gastroenterology and Liver Centre Royal Prince Alfred Hospital  Sydney New South Wales Australia"},{"name":"Sydney Medical School University of Sydney  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rhys","family":"Vaughan","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Austin Health  Melbourne Victoria Australia"},{"name":"Faculty of Medicine, Dentistry and Health Sciences University of Melbourne  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marios","family":"Efthymiou","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Austin Health  Melbourne Victoria Australia"},{"name":"Faculty of Medicine, Dentistry and Health Sciences University of Melbourne  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,10,8]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.4254\/wjh.v13.i1.66"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v24.i19.2061"},{"key":"e_1_2_6_4_1","first-page":"316","article-title":"Management of biliary strictures after liver transplantation","volume":"11","author":"Villa NA","year":"2015","journal-title":"Gastroenterol. 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