Modern Management of Benign Bile Duct Strictures.

The diagnosis and treatment of benign biliary strictures (BBS) are often challenging. In the past, surgery was the treatment of choice in the majority of cases. Nowadays the endoscopic treatment of BBS is preferred over surgery because it is less invasive, repeatable and associated with lower morbidity rates. The endoscopic retrograde cholangiopancreatography (ERCP) can make the diagnosis of the stricture, and provide its dilation and stent placement. Temporary insertion of multiple side-by-side large-bore plastic stent is the standard of care in endoscopic therapy. The use of uncovered self-expanding metal stents is under investigation. Most commonly BBS occur in the evolution of chronic pancreatitis, and after liver transplant or cholecystectomy. The efficacy of endoscopic therapies is different and depends on the cause of BBS. Though it has limitations, endoscopic therapy has a favourable safety profile and remains a first-line management option in benign biliary strictures. Endoscopic therapy may be considered a bridge to surgery in some cases of chronic pancreatitis or in nonanastomotic strictures after liver transplant. [ABSTRACT FROM AUTHOR]