Biliary stricture

Al-Karawi, M., Sana , F.M., Yasawy, M.I., Mohammed, A.E. Biliary strictures and cholangitis secondary to ascaris endoscopic management. Gastrointest. Endosc. 1999 50 695-697... 

Rossi, R, Saivatori, F.M., Bezzi, M., Maccioni, R, Rorcaro, M.L., Ricci, R Percutaneous management of benign biliary strictures with balloon dilatation and selfexpanding metallic stents. Cardiovasc. Intervent. Radiol. 1990 13 231-239... 

Barquist, E.S., Goldstein, N., Ziner, M.X Polyarteritis nodosa presenting as a biliary stricture Surgery 1991 109 16-19... 

LDLT involving adults, the volume of the donor organ should be equivalent to approx. 1% of the body weight of the recipient. The respective size of the transplant, which is usually taken from the right lobe, is determined by means of CT volumetry. After LDLT, bile leaks (7-10%o) and biliary strictures (16-20%) frequently appear. In such suspected complications, ERC is recommended. (364, 376, 383, 392, 395, 411)... 

Clinical presentation. Bile duct complications develop within 2 months of chemoembolization but some may develop at a later stage [27]. Most patients with biliary strictures remain asymptomatic until the lumen of the bile duct is sufficiently narrowed to cause resistance to the flow of bile. Occasionally, patients may have intermittent episodes of RUQ (biliary colic), with or without laboratory features of biliary obstruction. 

The Gianturco stent is seldom used in the treatment of mahgnant biliary strictures because of the high rates of tumor ingrowth through the wide mesh. 

Burcharth F (1978) A new endoprosthesis for nonoperative intubation of the biliary tract in malignant obstructive jaundice. Surg Gynecol Obstet 146 76 Catalano MF, Geenen JE, Lehman GA et al (2002) Tannen-baum Teflon stents versus traditional polyethylene stents for treatment of malignant biliary stricture. Gastrointest Endosc 55 354-358... 

Funaki B, Zaleski GX, Straus CA, Leef JA, Funaki AN, Lorenz J, Farrell TA, Rosenblum JD (2000) Percutaneous biliary drainage in patients with non-dilated intrahepatic bile ducts. AJR Am J Roentgenol 175 268 Gabelmann A, Hamid H, Brambs HJ et al (2001) Metallic stents in benign biliary strictures long-term effectiveness and interventional management of stent occlusion. AJR Am J Roentgenol 177 813 17... 

Seibert DG (1997) Biliary stricture measurement and stent selection. Am J Gastroenterol 92 1510-1514 Seitz U, Vadeyar H, Soehendra N (1994) Prolonged patency with a new-design Teflon biliary prosthesis. Endoscopy 26 478-482... 

Navaneethan U, Parsi MA, Gutierrez NG, et al. Volatile organic compounds in bile can diagnose malignant biliary strictures in the setting of pancreatic cancer a preliminary observation. Gastrointest Endosc. 2014 80 1038-45. 

Fig. 4.1.6. Apparent anastomotic biliary stricture due to donor-to-recipient bile duct diameter discrepancy...

Non-anastomotic biliary strictures occur secondary to hepatic artery thrombosis or stenosis, preservation injury, ABO blood group incompatibility, and chronic ductopenic rejection. They are frequently multiple. Isolated non-anastomotic strictures of the donor extra-hepatic or intra-hepatic biliary tree may... 

MRCP is helpful in the detection of biliary strictures, bile leaks, and biloma formation. Thick-slab MRCP images are particularly useful in the presence of biliary dilatation (Fig. 4.2.25). However, proximal biliary dilatation may be absent in the transplanted patient with stenosis at the anastomotic site (Laghi et al. 1999 Pandharipande et al. 2001). Careful analysis of thin-slice MR images can help to identify the stricture and/or leak (Fig. 4.2.26). False MR positive and negative results may occur in the presence of surgical clips due to susceptibility artifact obscuring the biliary ducts. 

Non-anastomotic biliary strictures and dilations are the result of ischemic insults to the bile ducts only within the graft (Boraschi et al. 2004). Non-anastomotic strictures are probably the result of microcirculatory problems and they usually... 

MR imaging may have an advantage over endo-scopicretrogradecholangiopancreatography(ERCP) in those patients with biliary strictures in vdiom the biliary ducts proximal to the anastomosis are not dilated and/or well opacified during the ERCP procedure. Similarly, overdistention of the biliary ducts during the injection of contrast at ERCP in patients with biliary strictures maybe misinterpreted as donor-recipient size mismatch (Fig. 4.2.27). 

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