Multidisciplinary Management of Benign Biliary Strictures

Divya Deverakonda; Chase J. Wehrle; Hassan Siddiki; Koji Hashimoto; Andrea Schlegel; Sameer Gadani

doi:10.1055/s-0044-1801818

Digestive Disease Interventions, Inhaltsverzeichnis

Digestive Disease Interventions
DOI: 10.1055/s-0044-1801818

Review Article

Multidisciplinary Management of Benign Biliary Strictures

Autor*innen

Divya Deverakonda

¹Department of General Surgery, Digestive Disease Institute, Cleveland Clinic Foundation, Cleveland, Ohio
Chase J. Wehrle

²Transplant Enterprise, Cleveland Clinic Foundation, Cleveland, Ohio
Hassan Siddiki

³Department of Gastroenterology, Advanced Endoscopy Section, Cleveland Clinic Foundation, Cleveland, Ohio
Koji Hashimoto

²Transplant Enterprise, Cleveland Clinic Foundation, Cleveland, Ohio
Andrea Schlegel

²Transplant Enterprise, Cleveland Clinic Foundation, Cleveland, Ohio
Sameer Gadani

⁴Department of Interventional Radiology, Cleveland Clinic Foundation, Cleveland, Ohio

Abstract

Benign biliary strictures can occur as sequelae after inflammatory processes of the hepato-pancreato-biliary system; they can also occur as a major complication after liver and pancreas surgery. Such strictures are so strongly associated with outcomes after liver and pancreas surgery that they are now included as a required “core outcome” for reporting after a liver transplant. Options for the management of benign biliary strictures include endoscopic, percutaneous, and surgical techniques. Retrograde endoscopy or antegrade percutaneous interventions are first-line therapies, with surgical management reserved for recalcitrant cases. Overall, biliary strictures are best managed by multidisciplinary teams at tertiary-care centers to ensure that the most advanced and least invasive approaches are available. This article reviews all three techniques for the management of benign biliary strictures, with a focus on multidisciplinary approaches for complex stricture disease.

Keywords

biliary stricture - endoscopic stenting - endoscopic retrograde cholangiopancreatography - percutaneous transhepatic cholangiography

Volltext

Referenzen

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