Interobserver Agreement for Classifying Post-liver Transplant Biliary Strictures in Donation After Circulatory Death Donors

摘要: Biliary strictures are a common complication of donation after circulatory death (DCD) liver transplantation (LT) and require multiple endoscopic retrograde cholangiopancreatography (ERCP) procedures. Three classification systems, based on cholangiograms, have been proposed for categorizing post-LT biliary strictures. We examined the interobserver agreement each three classifications. DCD LT recipients from 2012 through March 2017 undergoing ERCP were included in study. Initial cholangiograms delineating entire tree prior to intervention selected. One representative cholangiogram was selected ERCP. Five interventional endoscopists independently viewed anonymized classified stricture according systems. The Ling proposes four types their location. Lee classes location number intrahepatic binary system classifies into anastomotic or non-anastomotic types. Krippendorff’s alpha reliability estimate used grade strength as “poor,” “fair,” “moderate,” “good,” “excellent” values between 0–0.20, 0.21–0.4, 0.41–0.6, 0.61–0.08, 0.81–1, respectively. hundred (age 57.07 ± 8.8 years; 71 males) initially evaluated. Of these, 49 patients who underwent 206 procedures analysis. thirty-nine subsequently by five endoscopists. Interobserver 0.354 (fair agreement), 0.405 0.421 (moderate agreement). provided least amount detail regarding currently available systems assessing sub-optimal agreement. A better-designed is needed