Endoscopic treatment for suprapancreatic biliary stricture following blunt abdominal trauma.

OBJECTIVES

Suprapancreatic biliary stricture associated with blunt abdominal trauma is extremely rare. Therefore, no definitive treatment modality for this stricture has been fully established. This study was designed to evaluate the efficacy and long-term follow-up of endoscopic treatment for suprapancreatic biliary stricture following blunt abdominal trauma.

METHODS

Data from the institution's prospectively collected endoscopic retrograde cholangiopancreatography (ERCP) database, medical records, radiological findings, and trauma registry with operative records were used to identify patients with suprapancreatic biliary stricture associated with blunt abdominal trauma.

RESULTS

Eight patients (six men and two women) with a median age of 36 yr (interquartile range [IQR] 29-53 yr) were included in this study. The median interval between the initial trauma and the onset of symptoms was 23 days (IQR 16-51 days). The median length of biliary stricture was 1 cm (IQR 0.6-1 cm). Endoscopic plastic stent placement was successfully performed in all patients included in the study. The median duration of stent placement was 2 months (IQR 2-2.8 months). Follow-up ERCP showed improved or resolved biliary stricture in all patients. There was no recurrence of symptoms after the removal of the stents; therefore, surgery was unnecessary in these patients. Long-term follow-up (median 33 months) was also excellent.

CONCLUSIONS

Endoscopic plastic stent placement may be a good candidate for first-line management for suprapancreatic biliary strictures following blunt abdominal trauma. Furthermore, the long-term results for this type of biliary stricture with endoscopic stent placement may be excellent.