Shrestha UK. Mitigating challenges in endoscopic management of post-liver transplant biliary strictures. World J Gastrointest Endosc 2026; 18(7): 123520 [DOI: 10.4253/wjge.123520]
Corresponding Author of This Article
Umid K Shrestha, MD, PhD, Professor, Department of Gastroenterology and Hepatology, Nepal Mediciti Hospital, Bhaisepati, Ward No. 18, Lalitpur 44700, Bagmati, Nepal. umidshrestha@gmail.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
editorial
Open-Access Policy of This Article
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World J Gastrointest Endosc. Jul 16, 2026; 18(7): 123520 Published online Jul 16, 2026. doi: 10.4253/wjge.123520
Mitigating challenges in endoscopic management of post-liver transplant biliary strictures
Umid K Shrestha
Umid K Shrestha, Department of Gastroenterology and Hepatology, Nepal Mediciti Hospital, Lalitpur 44700, Bagmati, Nepal
Author contributions: Shrestha UK contributed to the conceptualization and design, writing the original draft, and reviewing and editing.
AI contribution statement: AI tools were not used.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Corresponding author: Umid K Shrestha, MD, PhD, Professor, Department of Gastroenterology and Hepatology, Nepal Mediciti Hospital, Bhaisepati, Ward No. 18, Lalitpur 44700, Bagmati, Nepal. umidshrestha@gmail.com
Received: May 21, 2026 Revised: June 12, 2026 Accepted: June 17, 2026 Published online: July 16, 2026 Processing time: 57 Days and 2.4 Hours
Core Tip
Core Tip: Post-liver transplant biliary strictures (PTBS) are divided into anastomotic and non-anastomotic biliary strictures. Endoscopic therapy with balloon dilation of stricture followed by the placement of multiple plastic stents or fully covered self-expandable metal stents is currently the first-line therapy for PTBS. In cases of stricture recurrence, repeat endoscopic therapy remains a highly effective option. However, endoscopic treatment encounters challenges in certain conditions, such as tight or tortuous stenosis and altered anatomy, which are mitigated through advanced techniques, specialized stent designs, peroral cholangioscopy, deep enteroscopy and multidisciplinary approaches, thereby achieving long-term stricture resolution and reducing the need for surgery.
