Endoscopic management of postoperative biliary strictures

Postoperative biliary strictures most often occur after cholecystectomy and have become commoner in the laparoscopic cholecystectomy era. Encloscopic treatment of postoperative strictures is feasible in 85% of cases, and long-term success is achieved in over 80% of patients completing a treatment protocol. Endoscopic treatment typically requires placement of multiple stents for a prolonged period of time. The best outcomes have been achieved by increasing the duration of stenting and the number of stents until there is complete cholangiographic resolution of the stricture. Excluding strictures after liver transplantion, this article reviews the pathogenesis, classification, and endoscopic management of postoperative biliary stenoses.