Benign biliary strictures: Prevalence, impact, and management strategies

Abstract

Benign biliary strictures (BBSs) may form from chronic inflammatory pancreati-cobiliary pathologies, postoperative bile-duct injury, or at biliary anastomoses following liver transplantation. Treatment aims to relieve symptoms of biliary obstruction, maintain long-term drainage, and preserve liver function. Endoscopic therapy, including stricture dilatation and stenting, is effective in most cases and the first-line treatment of BBS. Radiological and surgical therapies are reserved for patients whose strictures are refractory to endoscopic interventions. Response to treatment is dependent upon the technique and accessories used, as well as stricture etiology. In this review, we discuss the various BBS etiologies and their management strategies. Keywords: benign biliary stricture, endoscopic retrograde cholangiopancreatography, metal stent, plastic stent, stricture dilatation, chronic pancreatitis, liver transplantation, primary sclerosing cholangitis.