Current management of biliary strictures

The definitive management of benign biliary strictures depends upon numerous factors, including the complexity and location of the stricture, the degree of inflammation and fibrosis, the presence of ongoing infection or sepsis, and the capability and experience of the surgeon and interventional radiologist at the institution.For some,such as high-risk or compromised patients or those with anastomotic strictures, percutaneous or endoscopic techniques may be most appropriate not only for diagnosis and delineation of the anatomy, but also as initial forms of management. However, successful outcomes regarding the management of most benign biliary strictures requires careful planning by a multidisciplinary team with regard to preoperative preparation, thorough diagnostic studies, and appropriate operative approach.Whatever most appropriate treatment option is selected, the need for careful long-term follow-up must be strongly emphasized, as no therapy is totally free of stricture recurrence.