title: Role of endoscopic retrograde cholangiopancreatography in the management of benign biliary strictures: What's new?
abstract: Benign biliary strictures comprise a heterogeneous group of diseases. The most common strictures amenable to endoscopic treatment are post-cholecystectomy, post-liver transplantation, related to primary sclerosing cholangitis and to chronic pancreatitis. Endoscopic treatment of benign biliary strictures is widely used as first line therapy, since it is effective, safe, noninvasive and repeatable. Endoscopic techniques currently used are dilation, multiple plastic stents insertion and fully covered self-expandable metal stents. The main indication for dilation alone is primary sclerosing cholangitis related strictures. In the vast majority of the remaining cases, temporary placement of multiple plastic stents with/without dilation is considered the treatment of choice. Although this approach is effective, it requires multiple endoscopic sessions due to the short duration of stent patency. Fully covered self-expandable metal stents appear as a good alternative to plastic stents, since they have an increased radial diameter, longer stent patency, easier insertion technique and similar efficacy. Recent advances in endoscopic technique and various devices have allowed successful treatment in most cases. The development of novel endoscopic techniques and devices is still ongoing.
authors.affiliation: Rosa Ferreira, Rui Loureiro, António Alberto Santos, Marília Cravo, Gastroenterology Department, Hospital Beatriz Ângelo, 2674-514 Loures, Portugal.
authors.forename: Rosa
authors.initials: R
authors.lastname: Ferreira
authors.affiliation: Rosa Ferreira, Rui Loureiro, António Alberto Santos, Marília Cravo, Gastroenterology Department, Hospital Beatriz Ângelo, 2674-514 Loures, Portugal.
authors.forename: Rui
authors.initials: R
authors.lastname: Loureiro
authors.affiliation: Rosa Ferreira, Rui Loureiro, António Alberto Santos, Marília Cravo, Gastroenterology Department, Hospital Beatriz Ângelo, 2674-514 Loures, Portugal.
authors.forename: Nuno
authors.initials: N
authors.lastname: Nunes
authors.affiliation: Rosa Ferreira, Rui Loureiro, António Alberto Santos, Marília Cravo, Gastroenterology Department, Hospital Beatriz Ângelo, 2674-514 Loures, Portugal.
authors.forename: António Alberto
authors.initials: AA
authors.lastname: Santos
authors.affiliation: Rosa Ferreira, Rui Loureiro, António Alberto Santos, Marília Cravo, Gastroenterology Department, Hospital Beatriz Ângelo, 2674-514 Loures, Portugal.
authors.forename: Rui
authors.initials: R
authors.lastname: Maio
authors.affiliation: Rosa Ferreira, Rui Loureiro, António Alberto Santos, Marília Cravo, Gastroenterology Department, Hospital Beatriz Ângelo, 2674-514 Loures, Portugal.
authors.forename: Marília
authors.initials: M
authors.lastname: Cravo
authors.affiliation: Rosa Ferreira, Rui Loureiro, António Alberto Santos, Marília Cravo, Gastroenterology Department, Hospital Beatriz Ângelo, 2674-514 Loures, Portugal.
authors.forename: Maria Antónia
authors.initials: MA
authors.lastname: Duarte
keywords: Benign biliary strictures; Bile duct stricture; Cholecystectomy; Chronic pancreatitis; Endoscopic retrograde cholangiopancreatography; Liver transplantation; Primary sclerosing cholangitis; Stents