Jul 17, 2013

Endoscopic management of benign biliary strictures

Current Gastroenterology Reports
Jesús García-Cano


The majority of recent studies of benign biliary strictures (BBSs) have reported on treatment of stenotic injuries following cholecystectomy, orthotopic liver transplantation, living donor liver transplantation, chronic pancreatitis, and different inflammatory conditions such as common bile-duct-related strictures. Information about previous surgical procedures is very important for making a BBS diagnosis. Diagnostic tools for indeterminate strictures have increased to include (1) highly specialized cytological techniques such as fluorescence in situ hybridization, (2) cholangioscopy, and (3) endoscopic ultrasound with fine needle aspiration (FNA) and intraductal ultrasound. Magnetic resonance cholangiopancreatography before endoscopic retrograde cholangiopancreatography (ERCP) usually provides an adequate map to plan the endoscopic therapy. After traversing the stricture with a guidewire and, occasionally, performing balloon dilatation, plastic stents continue to be the basic endotherapy, trying to insert the maximum possible number, with an exchange every 3 months during a 12-month period. Progressive stenting requires a median number of five ERCPs; therefore, it is technically demanding and burdensome but has an average of 8...Continue Reading

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Mentioned in this Paper

Endoscopy (Procedure)
Entire Duct
Fluorescent in Situ Hybridization
Cytological Techniques
Stent, Device
Retrograde Degeneration
Pathological Dilatation
Transplantation of Liver
Fine Needle Aspiration Biopsy

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