The Role Of Interventional Radiologists In Management Of Benign Biliary Strictures


Interventional Radiologist Department of Radiology, Tabriz University of Medical Sciences, Tabriz, Iran


Benign biliary strictures are most commonly iatrogenic in nature and are typically the result of surgical
injury. Postoperative strictures can be broadly divided into anastomotic and nonanastomotic strictures. Anastomotic strictures typically  develop in patients who have undergone previous cholecystectomy (especially laparoscopic cholecystectomy), hepatobiliary surgery or liver transplantation. Liver transplant patients have a relatively higher incidence of biliary anastomotic stricture than those with other types of abdominal surgeries.
Common etiologies for nonanastomotic benign biliary strictures include cholangitis, ischemic injury during liver transplantation, and cholelithiasis. Clinical manifestations of benign biliary strictures include jaundice, fever, elevated levels of serum alkaline phosphatase, and bilirubin.
In cases of failed ERCP , Roux-en-Y reconstruction or those with esophageal or upper gastrointestinal obstruction, alternative approaches are percutaneous interventions to access the bile ducts for diagnosis and treatment of benign biliary strictures.
Interventional radiologists play a vital role in the management of benign biliary strictures by providing percutaneous transhepatic biliary drainage(PTBD), balloon dilation, stent placement and stone removal.
The purpose of this review is to summarize percutaneous techniques , complications, and novel techniques for management of benign biliary strictures.