Modern Management of Benign Bile Duct Strictures

Benign biliary strictures (BBS) are a heterogeneous group of disorders whose diagnosis and treatment may be challenging. Surgical injury of the bile duct is the most common cause in the Western world (1). Inflammatory lesions of the biliary ducts, such as chronic pancreatitis represent the second most common cause of BBS.
The appropriate evaluation and management frequently require collaboration between gastroenterologists, surgeons and radiologists. The confirmation of the stricture is preferably made by magnetic resonance cholangiopancreatography (MRCP). A mainstay of diagnosis is the differentiation of BBS from malignant obstructions which are more prevalent. Tissue sampling during ERCP or endoscopic ultrasound with fine needle aspiration can be useful.