Benign biliary stricture--should they be dilated or treated surgically?

Management of benign biliary stricture remains a challenge for both surgeons and therapeutic endoscopists. Traditionally, surgery is considered the mainstay of treatment, but it is associated with significant morbidity and variable long-term outcome. With advances in endoscopic techniques and accessories, endoscopic management is emerging as an effective option. Outcome of endoscopic management depends on both the etiology and location of stricture. Current data suggest that long-term results with multiple plastic stents are superior to those with single plastic stent. Removable covered metal stents are a good alternative. The role of bio-absorbable self-expanding stents needs to be evaluated further.