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  • Title: Traumatic neuroma of extrahepatic bile ducts after orthotopic liver transplantation.
    Author: Herrera L, Martino E, Rodríguez-Sanjuán JC, Castillo J, Casafont F, González F, Figols J, Casanueva J, Cagigas M, Gómez-Fleitas M.
    Journal: Transplant Proc; 2009 Apr; 41(3):1054-6. PubMed ID: 19376425.
    Abstract:
    Traumatic neuromas (TN) of the biliary tree causing strictures have only occasionally been described after liver transplantation. Herein, we have reported 15 cases of TN that were detected between 1 and 17 months after transplantation (median: 4 months) during surgery for obstructive jaundice (12 cases), after alterations of liver function tests (two cases), or incidentally discovered after retransplantation (n = 1) we resected the lesion and the biliary anastomosis. Pathological examination and immunostaining for S-100 protein were performed to study the nerve fascicles. After a median follow-up time of 64 months (range = 0-127), 10 patients are alive without any complication related to the previous biliary TN. We propose the following classification: type I: TN originating from and located in the main biliary tract wall, and type II: TN arising from the surrounding tissues next to the main biliary tract. We conclude that TN are not uncommon after liver transplantation and that they are sometimes symptomatic, causing a biliary stricture that requires surgical treatment. We propose a classification to help patient selection for surgery. In our opinion, resection of the TN is the operation of choice, together with resection of the involved biliary tract in type I TN.
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