Role of endoscopic retrograde cholangiopancreatography inthe management of benign biliary strictures： What＇s new？

• 来源期刊: 世界胃肠内镜杂志：英文版（电子版）
• 学科: 医学
• 关键词: BENIGN biliary STRICTURES Bile duct STRICTURE Endoscopic retrograde CHOLANGIOPANCREATOGRAPHY STENTS Cholecystectomy Liver transplantation Primarysclerosing CHOLANGITIS Chronic pancreatitis
• 年，卷（期）: 2016,（4）
• 页码范围: 220-231
• 页数: 12页
• 分类号: R

摘要

Benign biliary strictures comprise a heterogeneous groupof diseases. The most common strictures amenableto endoscopic treatment are post-cholecystectomy,post-liver transplantation, related to primary sclerosingcholangitis and to chronic pancreatitis. Endoscopic treatmentof benign biliary strictures is widely used as firstline therapy, since it is effective, safe, noninvasive andrepeatable. Endoscopic techniques currently used aredilation, multiple plastic stents insertion and fully coveredself-expandable metal stents. The main indication fordilation alone is primary sclerosing cholangitis relatedstrictures. 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 multipleendoscopic sessions due to the short duration of stentpatency. Fully covered self-expandable metal stentsappear as a good alternative to plastic stents, since theyhave an increased radial diameter, longer stent patency,easier insertion technique and similar efficacy. Recentadvances in endoscopic technique and various deviceshave allowed successful treatment in most cases.The development of novel endoscopic techniques anddevices is still ongoing.