Endoscopic management of benign biliary strictures

Area of Science:

• Gastroenterology
• Interventional Endoscopy

Background:

• Benign biliary strictures frequently require endoscopic retrograde cholangiopancreatography (ERCP).
• Endoscopic management has become the standard of care over the past two decades.
• Common causes include post-surgical complications and chronic pancreatitis.

Purpose of the Study:

• To review the current endoscopic management strategies for benign biliary strictures.
• To discuss the evolving role of different stenting techniques.

Main Methods:

• Review of current literature and clinical practice regarding benign biliary stricture management.
• Emphasis on endoscopic retrograde cholangiopancreatography (ERCP) and stenting techniques.
• Consideration of imaging, stenting options, and multidisciplinary team approach.

Main Results:

• Sequential placement of multiple plastic biliary stents remains the preferred endoscopic approach.
• Covered metal stents show potential but require careful consideration due to mixed efficacy reports, cost, and complications.
• High-quality imaging is crucial for planning endoscopic interventions.

Conclusions:

• Optimal management of benign biliary strictures involves a collaborative, multidisciplinary team.
• Plastic stent placement is the current standard, while metal stents warrant cautious evaluation.
• Continued evolution of endoscopic techniques improves patient outcomes.