Interventional Management of Benign Biliary Strictures

Abstract Biliary strictures can occur due to benign and malignant etiologies, of which ∼30% are due to benign causes. The diagnosis of benign biliary strictures (BBSs) is often missed or delayed as many cases present with subtle clinical findings. Clinical presentation in these patients is often variable ranging from asymptomatic to cholangitis and sepsis. Diagnosis can be done using various modalities like ultrasound, computed tomography, and magnetic resonance imaging. Imaging helps identify the stricture location, extent as well as etiology of obstruction. Management of BBS requires a multidisciplinary approach of surgeon, gastroenterologist, and interventional radiologist. The percutaneous approach provides an alternative to surgery or endoscopic-guided procedures in biliary stricture treatment with the main advantages being rapid decompression of the biliary system and prompt relief of cholangitis. This review provides an overview of various percutaneous management techniques by interventional radiologists. The various percutaneous techniques like percutaneous transhepatic biliary drainage, balloon dilatation, plastic or biodegradable stents, magnetic compression anastomosis, and percutaneous endobiliary radiofrequency ablation are discussed.