SpyGlass cholangioscopy-assisted guidewire placement for post-LDLT biliary strictures: a case series.

Background and

Aims: Anastomotic biliary strictures are common in patients that undergo living donor liver transplantation. Although endoscopic management has the advantage over percutaneous approaches, the initial success rate for the endoscopic management is unsatisfactory. The SpyGlass system can be a useful device in patients with a severe anastomotic stricture.

Methods: The SpyGlass cholangioscopy-assisted guidewire placement was performed in 15 patients with a difficult guidewire placement in which the guidewire could not transverse the stricture with conventional methods for 10 min or more.

Results: The visualization rate of the stricture orifice was 93.3 % (14 of 15 patients). The total success rate of the SpyGlass cholangioscopy-assisted guidewire placement was 60 % (9 of 15 patients). No procedure-related complications occurred during or after the SpyGlass cholangioscopy-assisted guidewire placement.

Conclusions: This series demonstrated that the SpyGlass cholangioscopy-assisted guidewire placement is a useful method when the guidewire passage of the strictures site is impossible by conventional methods.