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Patients with esophageal strictures often experience a range of symptoms. Initially, they may have difficulty swallowing solid foods, which can progress to include liquids. Additional symptoms may involve chest pain or discomfort, regurgitating food and fluids, heartburn, unintentional weight loss, coughing or choking during meals, and hoarseness.
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Esophageal strictures involve abnormal narrowing or tightening of the esophagus. They vary in length and severity, ranging from mild constriction to complete obstruction, and are classified as benign (noncancerous) or malignant (cancerous).
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An Esophagogastroduodenoscopy (EGD) is a diagnostic procedure in which an endoscopist uses a flexible, lighted endoscope to visualize the upper gastrointestinal (GI) tract. The procedure includes visualizing the oropharynx, esophagus, stomach, and the first part of the small intestine, the duodenum.
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Endoscopy is a non-surgical medical technique used to examine a person's internal organs and vessels. This lesson will focus on two types of endoscopic studies: bronchoscopy and thoracoscopy.
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Biliary Endoscopy for Benign and Malignant Biliary Strictures.

Mina S Makary1, Jeffrey J Farrell1, Mamdouh Khayat1

  • 1Department of Radiology, Division of Vascular and Interventional Radiology, The Ohio State University Wexner Medical Center, Columbus, OH.

Techniques in Vascular and Interventional Radiology
|October 19, 2019
PubMed
Summary

Percutaneous endoscopy offers a viable alternative for diagnosing and treating biliary strictures when other methods fail. Interventional radiologists can effectively manage these cases by considering clinical and technical factors.

Keywords:
Percutaneous endoscopybenign biliary stricturesinterventional radiologymalignant biliary strictures

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Area of Science:

  • Interventional Radiology
  • Gastroenterology
  • Biliary Interventions

Background:

  • Biliary strictures, both benign and malignant, pose significant diagnostic and therapeutic challenges.
  • Endoscopic retrograde cholangiopancreatography (ERCP) is a common modality but can be limited by surgically altered anatomy or failure.
  • Percutaneous endoscopy presents a promising alternative in complex biliary cases.

Purpose of the Study:

  • To review the clinical evaluation, perioperative management, and procedural techniques for percutaneous biliary endoscopy.
  • To highlight the role of interventional radiologists in managing biliary strictures.
  • To discuss the utility of percutaneous endoscopy when ERCP is not feasible.

Main Methods:

  • Review of clinical evaluation protocols for patients with biliary strictures.
  • Discussion of perioperative management strategies for percutaneous procedures.
  • Detailed explanation of technical procedural aspects of percutaneous biliary endoscopy.

Main Results:

  • Percutaneous endoscopy is an effective tool for diagnosis and treatment of biliary strictures.
  • It offers a solution for cases where ERCP is unsuccessful or anatomically impossible.
  • Successful outcomes depend on careful consideration of preoperative clinical and technical factors.

Conclusions:

  • Percutaneous endoscopy by interventional radiologists is a valuable approach for biliary stricture management.
  • It expands treatment options for patients with challenging biliary anatomy or ERCP failure.
  • Comprehensive evaluation and meticulous technique are crucial for optimal patient outcomes.