Management of Benign Biliary Stricture in Chronic Pancreatitis

Mohan Ramchandani; Partha Pal; Guido Costamagna

doi:10.1016/j.giec.2023.04.002

Management of Benign Biliary Stricture in Chronic Pancreatitis

Gastrointest Endosc Clin N Am. 2023 Oct;33(4):831-844. doi: 10.1016/j.giec.2023.04.002. Epub 2023 May 11.

Authors

Mohan Ramchandani¹, Partha Pal², Guido Costamagna³

Affiliations

¹ Department of Medical Gastroenterology, Asian Institute of Gastroenterology, 6-3-661, Somajiguda, Hyderabad, Telangana, India; Interventional Endoscopy, AIG Hospitals, Plot No 2/3/4/5 Survey, 1, Mindspace Road, Gachibowli, Hyderabad, Telangana 500032, India. Electronic address: ramchandanimohan@gmail.com.
² Department of Medical Gastroenterology, Asian Institute of Gastroenterology, 6-3-661, Somajiguda, Hyderabad, Telangana, India.
³ Department of Translational Medicine and Surgery, Catholic University, Rome.

PMID: 37709414
DOI: 10.1016/j.giec.2023.04.002

Abstract

Endoscopic therapy is the first line of management for chronic pancreatitis (CP)-related benign biliary strictures. Multiple plastic stents (MPS) exchanged at regular intervals and temporary placement of fully covered self-expanding metal stents (FCSEMS) are preferred modalities of endotherapy. FCSEMS placement is non-inferior to MPS and requires fewer sessions of endoscopic retrograde cholangiopancreatography than MPS placement. The presence of head calcifications, severe CP, and length of stricture are predictors of failure or recurrence after endotherapy. Failure of endotherapy should be considered after 1 year when surgery should be considered.

Keywords: Benign biliary stricture; Chronic pancreatitis; Endoscopic retrograde cholangiopancreatography; Plastic stent; Self-expandable metal stent; Surgery.

Publication types

Review

MeSH terms

Cholangiopancreatography, Endoscopic Retrograde*
Constriction, Pathologic / etiology
Constriction, Pathologic / surgery
Humans
Pancreatitis, Chronic* / complications
Pancreatitis, Chronic* / therapy
Stents