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Related Experiment Videos

Benign biliary strictures. Surgery or endoscopy?

P H Davids1, A K Tanka, E A Rauws

  • 1Hepato-Pancreatic-Biliary Unit, Academic Medical Center, University of Amsterdam, The Netherlands.

Annals of Surgery
|March 1, 1993
PubMed
Summary
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Surgery and endoscopic stenting offer comparable long-term success for benign biliary strictures. Surgery is indicated for complex cases, while endoscopic stenting is a viable initial treatment for most patients.

Area of Science:

  • Gastroenterology
  • Surgical Gastroenterology
  • Biliary Medicine

Background:

  • Benign biliary strictures are often treated with surgery, which has historically shown over 80% long-term success.
  • Endoscopic stenting presents a potential alternative, with reported similar outcomes.

Purpose of the Study:

  • To compare the efficacy and outcomes of surgical versus endoscopic treatment for benign biliary strictures.
  • To evaluate long-term success rates and complication profiles of both treatment modalities.

Main Methods:

  • A retrospective study included 101 patients with benign biliary strictures, 35 treated surgically and 66 endoscopically.
  • Surgical treatment involved biliary-digestive anastomosis; endoscopic treatment utilized stenting with regular exchanges over one year.

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Main Results:

  • Mean follow-up was 50 months for surgery and 42 months for endoscopy.
  • Early complications were more frequent in the surgical group (p < 0.03).
  • Late complications occurred only in the endoscopic group, with 17% recurrent stricturing in both groups.

Conclusions:

  • Both surgery and endoscopic stenting demonstrate similar long-term success rates for benign biliary strictures.
  • Surgical intervention is recommended for complete transections, failed prior repairs, or endoscopic failures.
  • Endoscopic stenting is suitable as an initial treatment for most other benign biliary stricture cases.