Parsi MA. Common controversies in management of biliary strictures. World J Gastroenterol 2017; 23(7): 1119-1124 [PMID: 28275292 DOI: 10.3748/wjg.v23.i7.1119]
Corresponding Author of This Article
Mansour A Parsi, MD, MPH, Center for Endoscopy and Pancreatobiliary Disorders, Department of Gastroenterology and Hepatology, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, United States. parsim@ccf.org
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Editorial
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. Feb 21, 2017; 23(7): 1119-1124 Published online Feb 21, 2017. doi: 10.3748/wjg.v23.i7.1119
Common controversies in management of biliary strictures
Mansour A Parsi
Mansour A Parsi, Center for Endoscopy and Pancreatobiliary Disorders, Department of Gastroenterology and Hepatology, Cleveland Clinic, Cleveland, OH 44195, United States
Author contributions: Parsi MA solely designed, wrote and edited the manuscript.
Conflict-of-interest statement: No conflicts of interest related to this manuscript.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Mansour A Parsi, MD, MPH, Center for Endoscopy and Pancreatobiliary Disorders, Department of Gastroenterology and Hepatology, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, United States. parsim@ccf.org
Telephone: +1-216-4454880 Fax: +1-216-4446284
Received: September 14, 2016 Peer-review started: September 16, 2016 First decision: November 21, 2016 Revised: December 10, 2016 Accepted: January 18, 2017 Article in press: January 18, 2017 Published online: February 21, 2017 Processing time: 159 Days and 13.4 Hours
Core Tip
Core tip: Based on available evidence preoperative biliary drainage is not routinely indicated in resectable malignant strictures. However, it is appropriate in acute cholangitis, in severely symptomatic patients and in those with delayed surgery. In patients with unresectable hilar stricture, cross-sectional imaging is advised prior to attempt at palliative drainage. In such patients unilateral stenting during endoscopic retrograde cholangiopancreatography is adequate in most cases. Routine stenting of dominant strictures in primary sclerosing cholangitis patients is not recommended. Stenting of dominant strictures is appropriate if there is poor drainage of contrast after dilatation or concern for collapse of the bile duct compromising biliary drainage.
