Premium
Progress in the endoscopic management of benign biliary strictures
Author(s) -
GIBBONS JOHN C,
WILLIAMS STEPHEN J
Publication year - 1998
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/j.1440-1746.1998.tb00625.x
Subject(s) - medicine , endoscopic retrograde cholangiopancreatography , endoscopic ultrasound , pancreatitis , radiology , magnetic resonance cholangiopancreatography , endoscopy , anastomosis , primary sclerosing cholangitis , biopsy , magnetic resonance imaging , surgery , disease
Benign biliary strictures can now be effectively treated with endoscopic therapy in a variety of clinical situations. Despite recent developments in imaging techniques (endoscopic ultrasound and magnetic resonance imaging), it is often difficult to differentiate benign from malignant biliary strictures. The sensitivity of tissue diagnosis (cytology and needle biopsy) at endoscopic retrograde cholangiopancreatography (ERCP) remains poor (40–50%), and further diagnostic methods are required. Endoscopic therapy offers a definitive treatment in 70–90% of patients following post‐operative biliary stricture, including anastomotic strictures following liver transplant. Endoscopic therapy successfully achieves symptomatic, biochemical, and cholangiographic response, and may improve survival in patients with primary sclerosing cholangitis. Strictures secondary to chronic pancreatitis are resistant to standard endoscopic therapy and metallic endoprotheses have been trialed with varying success. Endoscopic therapy is technically difficult and should be performed in specialized centres using a multidisciplinary approach.