title: Benign Biliary Strictures: Diagnostic Evaluation and Approaches to Percutaneous Treatment.
abstract: Interventional radiologists are often consulted to help identify and treat biliary strictures that can result from a variety of benign etiologies. Mainstays of noninvasive imaging for benign biliary strictures include ultrasound, contrast-enhanced computed tomography and magnetic resonance imaging, magnetic resonance cholangiopancreatography, and computed tomography cholangiography. Endoscopic retrograde cholangiography is the invasive diagnostic procedure of choice, allowing both localization of a stricture and treatment. Percutaneous biliary interventions are reserved for patients who are not candidates for endoscopic retrograde cholangiography (eg, history of distal gastrectomy and biliary-enteric anastomosis to a jejunal roux limb). This review discusses the roles of percutaneous transhepatic cholangiography and biliary drainage in the diagnosis of benign biliary strictures. The methodology for crossing benign biliary strictures, approaches to balloon dilation, management of recalcitrant strictures (ie, large-bore biliary catheters and retrievable covered stents), and the expected outcomes and complications of percutaneous treatment of benign biliary strictures are also addressed.
authors.affiliation: Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA. Electronic address: Nicholas.Fidelman@ucsf.edu.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Fidelman
mesh_terms: D000293:Adolescent; D000328:Adult; D057785:Catheters; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000009:adverse effects / Q000295:instrumentation; D002779:Cholestasis / Q000175:diagnosis* / Q000628:therapy*; D003251:Constriction, Pathologic; D003952:Diagnostic Imaging / Q000379:methods*; D004106:Dilatation; D004322:Drainage; D004867:Equipment Design; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D015641:Radiography, Interventional / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D016896:Treatment Outcome; D018615:Ultrasonography, Doppler, Color
keywords: balloon dilation; benign biliary stricture; cholangioplasty; drainage