{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T01:03:13Z","timestamp":1788397393335,"version":"build-2803163510"},"reference-count":23,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"12","license":[{"start":{"date-parts":[[2021,8,29]],"date-time":"2021-08-29T00:00:00Z","timestamp":1630195200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2021,8,29]],"date-time":"2021-08-29T00:00:00Z","timestamp":1630195200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Liver Transpl"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:p>Postoperative biliary complications have been reported to occur in 10% to 33% of pediatric liver transplantation (LT) recipients. Percutaneous intervention has become the primary treatment method for these complications; however, the efficacy and outcomes of these patients have not been well studied. Institutional pediatric LT from 1998 to 2019 were retrospectively reviewed to determine the patients referred for percutaneous treatment of post\u2010LT biliary strictures. Clinical parameters, percutaneous transhepatic cholangiograms (PTCs), biliary catheter placement, cholangioplasty, and long\u2010term outcomes were analyzed. Of the 396 consecutive pediatric LT recipients during our study period, 50 (12.6%) were diagnosed with biliary strictures on PTC. LT biliary reconstructions were Roux\u2010en\u2010Y hepaticojejunostomy in 28 patients (56%), choledochojejunostomy in 11 patients (22%), and choledochocholedochostomy in 11 patients (22%). Median age at LT was 23.2\u00a0months (interquartile range [IQR], 10.9\u201090.6), and 14 patients (28%) developed hepatic artery thrombosis. A total of 44 patients (88%) were treated with internal\/external biliary catheters, of whom 38 (76%) underwent balloon cholangioplasty. By 12\u00a0months, 84% of patients had complete stricture resolution and catheter removal. Median total duration of catheter drainage was 152\u00a0days (IQR, 76\u2010308). A total of 8 patients required additional surgery (biliary reconstruction or repeat LT [re\u2010LT]) or died with a drainage catheter in place from complications unrelated to PTC intervention. Among the 6 patients (12%) treated with unilateral external biliary drainage catheters, 2 had catheters removed for inadequate drainage but then had spontaneous biliary obstruction resolution, 1 underwent duct reconstruction, and 3 required long\u2010term catheterization. Biliary strictures following pediatric LT can be successfully treated with internal\/external biliary drainage catheters and cholangioplasty if the stricture can be crossed. However, patients with isolated strictured ducts may require long\u2010term external catheter drainage until re\u2010LT or percutaneous obliteration of isolated ducts.<\/jats:p>","DOI":"10.1002\/lt.26095","type":"journal-article","created":{"date-parts":[[2021,5,11]],"date-time":"2021-05-11T21:26:38Z","timestamp":1620768398000},"page":"1788-1798","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":13,"title":["Management of Biliary Stricture in Pediatric Liver Transplantation Patients: Long\u2010Term Outcomes"],"prefix":"10.1097","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0678-4235","authenticated-orcid":false,"given":"Kimberly L.","family":"Yan","sequence":"first","affiliation":[{"name":"School of Medicine,David Geffen School of Medicine at UCLA, University of California, Los Angeles,Los Angeles,CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antoinette S.","family":"Gomes","sequence":"additional","affiliation":[{"name":"School of Medicine,David Geffen School of Medicine at UCLA, University of California, Los Angeles,Los Angeles,CA"},{"name":"Department of Radiological Sciences,David Geffen School of Medicine at UCLA,University of California, Los Angeles,Los Angeles"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Phillip A.","family":"Monteleone","sequence":"additional","affiliation":[{"name":"Department of Radiological Sciences,David Geffen School of Medicine at UCLA,University of California, Los Angeles,Los Angeles"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert S.","family":"Venick","sequence":"additional","affiliation":[{"name":"Department of Pediatric Gastroenterology,David Geffen School of Medicine at UCLA, University of California, Los Angeles,Los Angeles,CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sue V.","family":"McDiarmid","sequence":"additional","affiliation":[{"name":"Department of Pediatric Gastroenterology,David Geffen School of Medicine at UCLA, University of California, Los Angeles,Los Angeles,CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorge H.","family":"Vargas","sequence":"additional","affiliation":[{"name":"Department of Pediatric Gastroenterology,David Geffen School of Medicine at UCLA, University of California, Los Angeles,Los Angeles,CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglas G.","family":"Farmer","sequence":"additional","affiliation":[{"name":"Department of Surgery, Liver Transplantation,David Geffen School of Medicine at UCLA, University of California, Los Angeles,Los Angeles,CA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2021,8,29]]},"reference":[{"issue":"suppl 2","key":"lt26095-bib-0001-20250824","first-page":"S6","article-title":"Long\u2010term outcomes in pediatric liver transplantation","volume":"15","year":"2009","journal-title":"Liver Transpl"},{"key":"lt26095-bib-0002-20250824","doi-asserted-by":"crossref","first-page":"648","DOI":"10.3748\/wjg.15.648","article-title":"Pediatric liver transplantation","volume":"15","year":"2009","journal-title":"World J Gastroenterol"},{"key":"lt26095-bib-0003-20250824","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1046\/j.1399-3046.2003.00127.x","article-title":"Biliary complications of living related pediatric liver transplant patients","volume":"8","year":"2004","journal-title":"Pediatr Transplant"},{"key":"lt26095-bib-0004-20250824","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1007\/s00270-009-9619-2","article-title":"Long\u2010term results of percutaneous bilioenteric anastomotic stricture treatment in liver\u2010transplanted children","volume":"33","year":"2010","journal-title":"Cardiovasc Intervent Radiol"},{"key":"lt26095-bib-0005-20250824","doi-asserted-by":"crossref","first-page":"1082","DOI":"10.1002\/lt.24180","article-title":"Biliary complications in pediatric liver transplantation: Incidence and management over a decade","volume":"21","year":"2015","journal-title":"Liver Transpl"},{"key":"lt26095-bib-0006-20250824","doi-asserted-by":"crossref","first-page":"1197","DOI":"10.1097\/01.TP.0000061940.96949.A1","article-title":"Split\u2010liver transplantation eliminates the need for living\u2010donor liver transplantation in children with end\u2010stage cholestatic liver disease","volume":"75","year":"2003","journal-title":"Transplantation"},{"key":"lt26095-bib-0007-20250824","doi-asserted-by":"crossref","first-page":"882","DOI":"10.1002\/lt.23896","article-title":"Diagnosis and management of biliary complications in pediatric living donor liver transplant recipients","volume":"20","year":"2014","journal-title":"Liver Transpl"},{"key":"lt26095-bib-0008-20250824","doi-asserted-by":"crossref","first-page":"214","DOI":"10.1016\/0022-3468(94)90321-2","article-title":"The spectrum of bile duct complications in pediatric liver transplantation","volume":"29","year":"1994","journal-title":"J Pediatr Surg"},{"key":"lt26095-bib-0009-20250824","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1097\/00007890-199202010-00024","article-title":"Biliary complications in pediatric liver transplantation. A comparison of reduced\u2010size and whole grafts","volume":"53","year":"1992","journal-title":"Transplantation"},{"key":"lt26095-bib-0010-20250824","doi-asserted-by":"crossref","first-page":"316","DOI":"10.1016\/S0022-3468(99)90199-9","article-title":"Late biliary complications in pediatric liver transplantation","volume":"34","year":"1999","journal-title":"J Pediatr Surg"},{"key":"lt26095-bib-0011-20250824","doi-asserted-by":"crossref","first-page":"358","DOI":"10.1111\/j.1399-3046.2009.01246.x","article-title":"Biliary strictures in pediatric liver transplant recipients\u2014early diagnosis and treatment results in excellent graft outcomes","volume":"14","year":"2010","journal-title":"Pediatr Transplant"},{"key":"lt26095-bib-0012-20250824","doi-asserted-by":"crossref","first-page":"821","DOI":"10.1002\/lt.20712","article-title":"Outcomes and risk factors for failure of radiologic treatment of biliary strictures in pediatric liver transplantation recipients","volume":"12","year":"2006","journal-title":"Liver Transpl"},{"key":"lt26095-bib-0013-20250824","doi-asserted-by":"crossref","first-page":"888","DOI":"10.1053\/jpsu.2001.23963","article-title":"Survival and outcome after hepatic artery thrombosis complicating pediatric liver transplantation","volume":"36","year":"2001","journal-title":"J Pediatr Surg"},{"key":"lt26095-bib-0014-20250824","first-page":"344","article-title":"Biliary strictures complicating liver transplantation. Incidence, pathogenesis, management, and outcome","volume":"216","year":"1992","journal-title":"Ann Surg"},{"key":"lt26095-bib-0015-20250824","doi-asserted-by":"crossref","first-page":"904","DOI":"10.1016\/j.jamcollsurg.2007.01.061","article-title":"Predictors of outcomes after pediatric liver transplantation: an analysis of more than 800 cases performed at a single institution","volume":"204","year":"2007","journal-title":"J Am Coll Surg"},{"key":"lt26095-bib-0016-20250824","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1016\/j.jamcollsurg.2017.12.042","article-title":"One thousand pediatric liver transplants during thirty years: lessons learned","volume":"226","year":"2018","journal-title":"J Am Coll Surg"},{"key":"lt26095-bib-0017-20250824","doi-asserted-by":"crossref","first-page":"845","DOI":"10.12659\/AOT.910528","article-title":"Percutaneous treatment of biliary strictures after pediatric liver transplantation","volume":"23","year":"2018","journal-title":"Ann Transplant"},{"key":"lt26095-bib-0018-20250824","doi-asserted-by":"crossref","first-page":"943","DOI":"10.2214\/ajr.151.5.943","article-title":"The role of sonography and transhepatic cholangiography in the diagnosis of biliary complications after liver transplantation","volume":"151","year":"1988","journal-title":"Am J Roentgenol"},{"key":"lt26095-bib-0019-20250824","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1111\/ajt.16270","article-title":"Subclinical biliary strictures as a cause of long\u2010term allograft dysfunction in children who underwent liver transplantation","volume":"21","year":"2021","journal-title":"Am J Transplant"},{"key":"lt26095-bib-0020-20250824","doi-asserted-by":"crossref","first-page":"1668","DOI":"10.1016\/j.jpedsurg.2010.03.010","article-title":"Biliary reconstruction in pediatric live donor liver transplantation: duct\u2010to\u2010duct or Roux\u2010en\u2010Y hepaticojejunostomy","volume":"45","year":"2010","journal-title":"J Pediatr Surg"},{"key":"lt26095-bib-0021-20250824","doi-asserted-by":"crossref","first-page":"993","DOI":"10.1007\/s00270-008-9378-5","article-title":"Percutaneous management of biliary strictures after pediatric liver transplantation","volume":"31","year":"2008","journal-title":"Cardiovasc Intervent Radiol"},{"key":"lt26095-bib-0022-20250824","doi-asserted-by":"crossref","first-page":"761","DOI":"10.2214\/ajr.176.3.1760761","article-title":"Percutaneous transhepatic cholangiography and biliary drainage in pediatric liver transplant patients","volume":"176","year":"2001","journal-title":"Am J Roentgenol"},{"issue":"suppl 2","key":"lt26095-bib-0023-20250824","first-page":"121","article-title":"Cancer risks following diagnostic and therapeutic radiation exposure in children","volume":"36","year":"2006","journal-title":"Pediatr Radiol"}],"container-title":["Liver Transplantation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lt.26095","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/lt.26095","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.lww.com\/10.1002\/lt.26095","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,24]],"date-time":"2025-08-24T21:02:26Z","timestamp":1756069346000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1002\/lt.26095"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,8,29]]},"references-count":23,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2021]]}},"URL":"https:\/\/doi.org\/10.1002\/lt.26095","relation":{},"ISSN":["1527-6465","1527-6473"],"issn-type":[{"value":"1527-6465","type":"print"},{"value":"1527-6473","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,8,29]]},"assertion":[{"value":"2021-02-28","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-05-03","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}