Recent modalities in management of recurrent biliary strictures

Abstract

Biliary stricture is a narrowing of the bile duct. This narrowing can cause blockage of the bile into small intestine. The management of recurrent biliary strictures presents a significant challenge to surgeons. If not recognized promptly or if managed improperly, severe complications may result; including cholangitis, portal hypertension, and biliary cirrhosis. Benign strictures of the biliary tract are associated with a broad spectrum of signs and symptoms, ranging from subclinical disease with mild elevation of liver enzymes to complete obstruction with jaundice, pruritus, cholangitis and ultimately biliary cirrhosis Initial imaging techniques employed regarding the evaluation of patients with postoperative biliary stricture include abdominal ultrasound and CT scan. The gold standard for the evaluation of patients with recurrent biliary stricture is cholangiography. Recently, magnetic resonance cholangiography has become the method of choice for the diagnosis and delineation of biliary stricture because of its high sensitivity and low complication rates.