Radiological Approach to Benign Biliary Strictures

Publication date: Available online 31 January 2015 Source:Gastrointestinal Intervention Author(s): Dong II. Gwon , Hans-Ulrich Laasch Benign biliary strictures can be due to a large variety of causes, but are commonly iatrogenic after direct or vascular injury during laparoscopic cholecystectomy and other biliary procedures. An increasing number of patients present with strictures of bilio-enteric anastomoses after liver transplantation and radical surgery for hepato-pancreatico-biliary (HPB) cancer. Endoscopic access to the biliary tree may be difficult or impossible following pancreatico-duodenectomy and in this context strictures are best approached percutaneously. In the past, strictures could only be managed with repeated balloon dilatations, and/or long-term transhepatic catheter placement. This is not very satisfactory from a patient point of view. A long-term external drain is disfiguring, challenging to manage and the patient has to undergo repeated, potentially very painful procedures. Newer developments attempting to achieve long-term resolution of benign strictures include fully covered, removable metal stents and the emerging option of biodegradable stents. Early outcomes of these new technologies are promising, but require a careful and considered multidisciplinary approach and heavy clinical involvement of the interventional radiologist.

Source: Gastrointestinal Intervention - January 31, 2015 Category: Gastroenterology Source Type: research