Current strategy of surgical treatment for postoperative benign biliary stricture

Abstract

Multidisciplinary therapy including biliary surgeon, gastroenterologists, interventional radiologists, endoscopists and other interprofessional team, is recommended for treatment of benign biliary stricture (BBS), especially surgical treatment have to be performed for intractable case of BBS that is not effective of repeat endoscopic or interventional radiological (IVR) treatment.

Exposure of healthy bile ducts without ischemia with a tension free repair is important for achieving optimal result in surgical treatment for BBS, therefore cases of hilar bile duct stricture such as Bismuth type III, IV and V might be performed hilar bile duct resection and cholangiojejunostomy with transhepatic approach. Even though some authors have reported good outcomes of endoscopic teqniques using with fully covered self-expandable metallic stent, surgical treatment is still necessary for refractory cases of BBS which resistant to endoscopic and IVR techniques.