Benign biliary strictures: Endoscopic management |
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| Affiliation: | 1. Digestive Endoscopy Unit, Catholic University, Largo A. Gemelli 8, 00168 Rome, Italy;2. Chair of Digestive Endoscopy, USIAS, Strasbourg University, Strasbourg, France;1. Division of Clinical Training, Department of Medical Education, Taipei Veterans General Hospital, Taipei, Taiwan, ROC;2. Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC |
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| Abstract: | Over the past 2 decades, endoscopic retrograde cholangiopancreatography with stricture dilation and stent placement has gradually become the first-line treatment modality for the vast majority of benign biliary strictures (BBSs). Stricture remediation with progressive placement of multiple plastic stents with 3 months interval stent exchange during a period of one year has excellent long-term results in patients with postoperative BBSs. Covered self-expandable metal stents (SEMS) are a reasonable alternative to multiple plastic stenting, especially in patients with chronic pancreatitis. The use of covered SEMS should be limited to carefully selected cases of postoperative BBSs. Uncovered SEMS are contraindicated for any type of BBSs. Understanding of the etiology and exclusion of malignancy is essential for optimal treatment in some types of biliary strictures, especially in the case of autoimmune cholangiopathy and primary sclerosing cholangitis. |
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| Keywords: | Plastic stents Self-expandable metal stents Chronic pancreatitis Laparoscopic cholecystectomy Liver transplantation primary sclerosing cholangitis Autoimmune cholangiopathy |
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