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Digestive and Liver Disease 48S2 (2016) e67–e231
e67
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Digestive and Liver Disease
j o u r n a l h ome p a g e : www. e l s ev i e r. c om / l o c a t e / d l d
VOLUME 48 SUPPLEMENT 1 FEBRUARY2016
ISSN 1590-8658
22ndNationalCongressofDigestiveDiseases
ItalianFederationofSocietiesof
DigestiveDiseases – FISMAD
Naples,24–27 February 2016
PC.01 Plenary Session
PC.01.1
MANAGEMENT OF BILIARY ANASTOMOTIC STRICTURE AFTER
LIVER TRANSPLANTATION (BASALT STUDY): RESULTS OF A
NATIONAL SURVEY IN ITALY
Cantù P.*
21
, Parzanese I.
21
, Balassone V.
1
, Di Sario A.
2
, Soggiu F.
3
,
Lombardi G.
4
, Barbaro F.
6
, Pisani A.
7
, Baldan A.
8
, Cariani G.
9
,
Boarino V.
10
, Fasoli A.
11
, Bertani H.
12
, Forti E.
13
, Bulajic M.
14
,
Ghinolfi D.
15
, Nadal E.
16
, Cerofolini A.
17
, Barresi L.
18
, Stroppa I.
1
,
Mazzaferro V.
3
, Cipolletta L.
4
, Tringali A.
6
, Costamagna G.
5
,
Ravelli P.
19
, Bazzoli F.
9
, Merighi A.
10
, Parodi M.C.
11
, Conigliaro R.
12
,
Mutignani M.
13
, Zilli M.
14
, Filipponi F.
15
, Fantin A.
16
, Rodella L.
17
,
Traina M.
18
, Rotondano G.
20
, Rosa R.
21
, Malinverno F.
22
, Donato F.
22
,
Colombo M.
22
, Conte D.
21
, Rossi G.
23
, Penagini R.
21
1
U.O.S.D. Endoscopia Digestiva Operativa e d’Urgenza, Fondazione
Policlinico Tor Vergata, Roma, Italy,
2
SOD Clinica di Gastroenterologia,
Epatologia ed Endoscopia Digestiva d’Urgenza, Azienda Ospedaliera
Universitaria Ospedali Riuniti di Ancona, Ancona, Italy,
3
S.C. Chirurgia
Generale ad indirizzo oncologico 1, Epato-gastro-pancreatico e
Trapianto di Fegato, Fondazione IRCCS Istituto Nazionale dei Tumori,
Milano, Italy,
4
U.O.S.C. Gastroenterologia, Azienda Ospedaliera di
Rilievo Nazionale Antonio Cardarelli, Napoli, Italy,
5
Endoscopia
Digestiva Chirurgica, Policlinico Universitario Agostino Gemelli,
Roma, Italy,
6
U.O.C. Endoscopia Digestiva Chirurgica, Policlinico
Universitario Agostino Gemelli, Roma, Italy,
7
U.O.C. Gastroenterologia
Universitaria, Azienda Ospedaliera Policlinico di Bari, Bari, Italy,
8
U.O.C. Gastroenterologia 1 - Epatologia e Trapiantologia, AO
Papa Giovanni XXIII, Bergamo, Italy,
9
U.O.C. Gastroenterologia ed
Endoscopia Digestiva, Policlinico S.Orsola-Malpighi, Bologna, Italy,
10
U.O.C. Gastroenterologia, Policlinico di Modena, Modena, Italy,
11
U.O.C. Gastroenterologia ed Endoscopia Digestiva, Ospedale San
Martino, Genova, Italy,
12
U.O. Endoscopia Digestiva, Nuovo Ospedale
Sant’Agostino Estense, Baggiovara, Italy,
13
U.O.C. Endoscopia
digestiva e Interventistica, Ospedale Niguarda Ca’ Granda, Milano,
Italy,
14
U.O.C. Gastroenterologia, Azienda Ospedaliero Universitaria
Santa Maria della Misericordia, Udine, Italy,
15
U.O.C. Chirurgia
Epatica e dei Trapianti di Fegato, Azienda Ospedaliero-Universitaria
Pisana, Pisa, Italy,
16
U.O.C. Gastroenterologia, Azienda Ospedaliera
di Padova, Padova, Italy,
17
U.O.C. Endoscopia Chirurgica d’Urgenza,
Azienda Ospedaliera Universitaria Integrata di Verona, Ospedale di
Borgo Trento, Verona, Italy,
18
U.O.C. Gastroenterologia e Endoscopia
Digestiva, Istituto Mediterraneo per i Trapianti e Terapie ad Alta
Specializzazione ISMETT, Palermo, Italy,
19
U.O.C. Gastroenterologia
2 - Endoscopia Digestiva, Azienda Ospedaliera Papa Giovanni XXIII,
Bergamo, Italy,
20
U.O.C. Gastroenterologia ed Endoscopia Digestiva,
Ospedale Maresca, Torre del Greco, Italy,
21
U.O.C. Gastroenterologia ed
Endoscopia, Dipartimento di Fisiopatologia e dei Trapianti, Fondazione
IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Università degli
Studi di Milano, Milano, Italy,
22
U.O.C. Gastroenterologia e Epatologia,
Dipartimento di Fisiopatologia e dei Trapianti, Fondazione IRCCS
Ca’ Granda, Ospedale Maggiore Policlinico, Università degl Studi di
Milano, Milano, Italy,
23
U.O.C. Chirurgia Epato-bilio-pancreatica,
Dipartimento di Fisiopatologia e dei Trapianti, Fondazione IRCCS
Ca’ Granda, Ospedale Maggiore Policlinico, Università degli Studi di
Milano, Milano, Italy
Background and aim:
An International Consensus on management
of biliary anastomotic stricture (AS) after liver transplantation (LT)
still lacks. Aim was to retrospectively report the overall workload
and to give a picture of the management of AS after LT in Italy.
Material and methods:
A questionnaire was sent to the Endoscopy
Units working with the 21 Italian Liver Transplantation Centers.
The questionnaire was composed of 5 topics including: 1. annual
workload (year 2013), 2. selection criteria (clinical, biochemical,
radiological) for endotherapy, 3. criteria to confirm the presence of
AS, 4. type of endotherapy, 5. treatment of recurrent AS.
Results:
Eighteen of the 21 Units returned the questionnaire.
1. Twelve out seventeen are high volume (> 250 ERCPs/year) Units.
During 2013, 170 of 705 (23%) liver transplanted pts underwent
endotherapy for AS. 319 (5.4%) out of a total of 5886 ERCPs (median/
Centre 13, range 5-60) were performed. Interventional radiology
or surgery was used in 3.5% and 2.4% of patients after unsuccessful
ERCP. In 5.6% of cases interventional radiology was preferred as first-
line treatment. In seven out of seventeen Units biliary complications
after hepatico-jejunal anastomosis were approached by enteroscopy.
2. In 83% of the Units selection criteria for ERCP included alteration
of liver tests associated with AS documented at non-invasive
imagings; biliary obstructive symptoms were additionally required
in the others. Trend of liver tests was considered in 83%; Magnetic
Resonance (MR) or T-tube cholangiography was used in 89%.
3. There was no consensus on operative criteria to confirm AS during
ERCP.
4. AS was treated by fully covered metal stent (SEMS) or plastic
multistenting (PM) in 6 Centers, PM only in 9 and single plastic
stenting in one. Use of fully covered SEMS was independent of
the overall ERCP workload of the Units. Fully covered SEMS were
used only transpapillary, being removed after three (25%) or six
Abstracts
22nd National Congress of Digestive Diseases,
Italian Federation of Societies of Digestive Diseases – FISMAD
Naples, 24–27 February 2016
Plenary sessions
1590-8658/© 2016 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.