Management of Recurrent Biliary Anastomotic Stricture After Pancreaticoduodenectomy Using a Bioabsorbable Stent: A...

Bilioenteric anastomotic strictures are a late complication of pancreaticoduodenectomy, often leading to recurrent biliary obstruction and cholangitis. Due to altered postoperative anatomy, percutaneous transhepatic interventions frequently represent the preferred therapeutic approach when endoscopic access is limited. Standard treatment consists of balloon dilation and placement of plastic or metallic stents, although these are associated with restenosis, occlusion, and the need for repeat procedures or device removal. Bioabsorbable stents have emerged as a potential alternative, providing temporary luminal support while eliminating the need for retrieval. We report a 70-year-old male with a history of pancreaticoduodenectomy and recurrent bilioenteric anastomotic stricture, previously managed with an internal-external biliary drain. A percutaneous transhepatic approach was performed under general anesthesia, including recanalization with a hydrophilic guidewire, balloon dilation, and deployment of a bioabsorbable stent. Final cholangiography demonstrated adequate biliary drainage without residual stenosis. Bioabsorbable stents may offer an effective, minimally invasive option in selected patients with complex biliary anatomy, potentially reducing the need for repeat interventions. Further studies are required to assess long-term patency and clinical outcomes.