ADVANCES IN ENDOSCOPIC MANAGEMENT OF HEPATICOJEUNOSTOMY ANASTOMOTIC STRICTURES

Abstract

Hepaticojejunostomy anastomotic stricture (HJAS) is a complicated clinical condition that has historically been treated with percutaneous transhepatic biliary drainage or surgical repair. The presence of long reconstructed gastrointestinal tract added to the complexity of the endoscopic treatment. However, recent advancements utilize less-invasive endoscopic approaches to HJAS; ERCP using a balloon-assisted endoscope and endoscopic ultrasonography-guided intervention. Balloon dilation combined with plastic stent placement has become the standard of care, whereas temporary placement of a fully-covered metal stent is reported to be a promising new modality. In this review, technical aspects of the endoscopic procedures for HJAS are discussed along with the literature review.