What is benign biliary stricture?
Benign biliary strictures (BBSs) may form from chronic inflammatory pancreaticobiliary pathologies, postoperative bile-duct injury, or at biliary anastomoses following liver transplantation. Treatment aims to relieve symptoms of biliary obstruction, maintain long-term drainage, and preserve liver function.
What causes benign biliary strictures?
The causes of benign bile duct strictures are usually surgical inexperience, failure to recognize abnormal biliary anatomy and congenital anomalies, acute inflammation, misplacement of clips, excessive use of cautery, and excessive dissection around the major bile ducts, resulting in ischemic injury.
How is biliary stricture treated?
A bile duct stricture is commonly treated by placing a small stent (a hollow tube) within the bile duct to keep it open. This procedure can be performed at the time of diagnosis with miniaturized surgical instruments inserted through the ERCP endoscope.
What percentage of biliary strictures are malignant?
A biliary stricture is an area of stenosis in the extrahepatic or intrahepatic biliary system. It can be the result of either benign or malignant pathologies, but unfortunately, the majority of biliary strictures are malignant (76–85%) at the time of diagnosis [1].
What is malignant stricture?
Malignant strictures are usually the result of either a primary bile duct cancer (ie, causing a narrowing of the bile duct lumen and obstructing the flow of bile) or extrinsic compression of the bile ducts by a neoplasm in an adjacent organ, such as the gallbladder, pancreas, or liver (see image below).
What is an Ampullary stricture?
1. On cholangiogram, long ampullary stenoses and fibrotic distal biliary strictures are not encountered infrequently and they are defined as a significant narrowing of the common bile duct (CBD) from the level of duodenal wall into CBD after initial ES.
Can bile duct blockage be cured?
The goal of treatment is to relieve the blockage. Stones may be removed using an endoscope during an ERCP. In some cases, surgery is required to bypass the blockage. The gallbladder will usually be surgically removed if the blockage is caused by gallstones.
What is the most common cause of benign bile duct strictures?
What is the most common site of benign bile duct tumors?
The part of the bile duct that is located outside of the liver is called “extrahepatic.” This location is where bile duct cancer is most commonly found.
Does anyone survive cholangiocarcinoma?
The 5-year survival rate for extrahepatic bile duct cancer is 10%. If the cancer is diagnosed in an early stage, the 5-year survival rate is 15%. If the cancer has spread to the regional lymph nodes, the 5-year survival rate is 16%.
What is the most common cause of benign biliary stricture?
The most common cause of benign biliary stricture in the United States is iatrogenic injury, most commonly due to complication following cholecystectomy or liver transplant. Injury to the common bile duct (CBD) during laparoscopic or open cholecystectomy accounts for the majority of iatrogenic bile duct injuries.
When do unifocal anastomotic Strictures occur in biliary patients?
Unifocal extrahepatic stricture occurring at the level of an injured extrahepatic bile duct. Single stricture seen at the level of a hepatoenteric or end-to-end biliary anastomosis due to scarring. Unifocal anastomotic or multifocal nonanastomotic strictures occur following OLT Duct injury following cholecystectomy Orthotropic liver transplant
Which is the best test for biliary ductal dilatation?
While ultrasound is a good screening tool for biliary ductal dilatation, it is limited by a poor negative predictive value. Magnetic resonance cholangiopancreatography is more than 95% sensitive and specific for detecting biliary strictures with the benefit of precise anatomic localization.
What are the different types of inflammatory strictures?
Inflammatory strictures A. Cholelithiasis or choledocholithiasis B. Chronic pancreatitis C. Chronic duodenal ulceration D. Abscess or inflammation of liver or subhepatic space E. Parasitic infection F. Recurrent pyogenic cholangitis (Oriental cholangiohepatitis) IV. Primary sclerosing cholangitis V. Radiation-induced stricture