Endoscopic management of benign biliary stricture

ABSTRACT

To present the experience of the Gastroenterology Department of the Riyadh Armed Forces Hospital, with endoscopic management of benign biliary strictures.Design: A retrospective study of patients diagnosed by endoscopic retrograde cholangiopancreatography [ERCP], as having benign biliary strictures. Thirty-seven patients with benign biliary strictures who were endoscopically diagnosed or treated over a 9-year period. Twenty-four of these patients had postoperative strictures and in the remaining 13 patients, the causes included sclerosing cholangitis, inflammation or benign neoplasm. The management in these patients was surgical in 18, combined surgical and endoscopic in ten and endoscopic only in nine. Nasobiliary drainage was performed in all ten cases of combined endoscopic and surgical approach before patients were referred to surgery. The last nine patients were managed by endoscopy alone, four had balloon dilatation and five had endoprostheses inserted [four of these were plastic stents and one was an expandable metal stent]. In benign biliary strictures, endoscopic management with stricture dilatation followed by stenting should be tried first before any surgical intervention is considered