Endoscopic management of bile duct strictures in kasr El Aini gastrointestinal endoscopy unit

ABSTRACT

Strictures of the biliary system may be benign or malignant, benign biliary strictures mostly occur as a result of surgical injury. Malignant strictures result from a neoplasm arising from the bile duct, ampulla of Vater, liver, gallbladder, or pancreas. Benign biliary strictures respond well after stenting with relief of cholangitis and jaundice. We aim by this study to evaluate the aetiology of Egyptian biliary strictures and the efficacy of its endoscopic management in Kasr El Aini Gastrointestinal Endoscopy Unit, Cairo University. Fifty patients with ERCP-confirmed biliary strictures [19 females and 31 males; age ranged 9-84 years with a mean of56.1 +/- 14.7 years] were included. Patients were subjected to routine laboratory investigations, abdominal ultrasonography, diagnostic and if possible therapeutic ERCP. The most common site of strictures was the distal; [52%], Hilar strictures followed [24%], the third common was mid CBD [14%.] Malignant strictures were present in [37/50; 74%] while benign strictures were present in 13/50 [26%]. The most common cause of malignant strictures was pancreatic carcinoma [15/37; 40.6%] followed by ampullary carcinoma [11/37; 29.7%] and cholangiocarcinoma [11/37; 29.7%]. Endoscopic biliary plastic stenting was done in 80% of cases. Endoscopic biliary drainge is a very effective technique for biliary strictures. Plastic endoprostheses is an effective tool in these strictures beside its low cost.