Endoscopic treatment of postoperative biliary strictures.

Benign postoperative biliary tract strictures may present with jaundice and/or cholangitis. Surgical reconstruction of these usually proximal biliary strictures carries high morbidity and mortality. In addition, recurrences following surgery are common. We attempted endoscopic therapy in 29 consecutive patients with benign biliary strictures, by the placement of one or two large-bore 10 French endoprostheses. The procedure was successful in 27 out of 29 (93%) patients. All 27 had rapid clearance of jaundice and/or cholangitis. Clinical follow-up of 21 patients for at least 6 months (range 6 months to 4 years) shows that 19 out of 21 have good (3) or excellent (16) results. There was no morbidity or mortality associated with the procedure. Although placement of an endoprosthesis in this group of patients is technically difficult, we believe it should be considered as the initial therapeutic modality in this clinical situation.