Multidisciplinary Management of Benign Biliary Strictures

Abstract Benign biliary strictures can occur as sequelae after inflammatory processes of the hepato-pancreato-biliary system; they can also occur as a major complication after liver and pancreas surgery. Such strictures are so strongly associated with outcomes after liver and pancreas surgery that they are now included as a required “core outcome” for reporting after a liver transplant. Options for the management of benign biliary strictures include endoscopic, percutaneous, and surgical techniques. Retrograde endoscopy or antegrade percutaneous interventions are first-line therapies, with surgical management reserved for recalcitrant cases. Overall, biliary strictures are best managed by multidisciplinary teams at tertiary-care centers to ensure that the most advanced and least invasive approaches are available. This article reviews all three techniques for the management of benign biliary strictures, with a focus on multidisciplinary approaches for complex stricture disease.