Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Review Article
  • Published:

Benign biliary strictures: current endoscopic management

Abstract

Endoscopic treatment is the mainstay of therapy for benign billiary strictures, and surgery is reserved for selected patients in whom endoscopic treatment fails or is not feasible. The endoscopic approach depends mainly on stricture etiology and location, and generally involves the placement of one or multiple plastic stents, dilation of the stricture(s), or a combination of these approaches. Knowledge of biliary anatomy, endoscopy experience and a well-equipped endoscopy unit are necessary for the success of endoscopic treatment. This Review discusses the etiologies of benign biliary strictures and different endoscopic therapies and their respective outcomes. Data on newer therapies, such as the placement of self-expandable metal stents, and the treatment of biliary–enteric anastomotic strictures is also reviewed.

Key Points

  • Benign biliary strictures (BBS) have diverse etiologies; endoscopic evaluation and therapy is the mainstay of treatment

  • Prognosis and duration of treatment of BBS depends mainly on stricture etiology, location and characteristics

  • For most BBS, placement of multiple, side-by-side, large-bore plastic stents that are exchanged periodically over approximately 1 year facilitates the best long-term results

  • Currently, the role of self-expandable metal stents for the treatment of BBS is controversial and more information will be available from forthcoming clinical trials

This is a preview of subscription content, access via your institution

Access options

Rent or buy this article

Prices vary by article type

from$1.95

to$39.95

Prices may be subject to local taxes which are calculated during checkout

Figure 1: Illustration of the Bismuth classification of biliary strictures.
Figure 2: The Strasberg classification of biliary injury.
Figure 3: A postcholecystectomy benign biliary stricture.
Figure 4: Benign biliary strictures associated with primary sclerosing cholangitis.
Figure 5: Magnetic resonance cholangiography in a patient with autoimmune cholangiopathy and autoimmune pancreatitis.
Figure 6: Autoimmune cholangiopathy seen on endoscopic retrograde cholangiopancretography.
Figure 7: Fully covered self-expandable metal stent (FCSEMS) for treatment of benign bile duct stricture.
Figure 8: Hepatico–jejunal anastomotic benign biliary stricture treated endoscopically.

Similar content being viewed by others

References

  1. MacFayden, B. V. et al. Bile duct injury after laparoscopic cholecystectomy. The United States experience. Surg. Endosc. 12, 315–321 (1998).

    Google Scholar 

  2. Windsor, J. A. & Pong, J. Laparoscopic biliary injury: more than a learning curve problem. Aust. N. Z. J. Surg. 68, 186–189 (1998).

    CAS  PubMed  Google Scholar 

  3. Pascher, A. & Neuhaus, P. Bile duct complications after liver transplantation. Transpl. Int. 18, 627–642 (2005).

    PubMed  Google Scholar 

  4. Davidoff, A. M. et al. Mechanisms of major biliary injury during laparoscopic cholecystectomy. Ann. Surg. 215, 196–202 (1992).

    CAS  PubMed  PubMed Central  Google Scholar 

  5. Bergman, J. J. et al. Treatment of bile duct lesions after laparoscopic cholecystectomy. Gut 38, 141–147 (1996).

    CAS  PubMed  PubMed Central  Google Scholar 

  6. Davidson, B. R. et al. Results of choledochojejunostomy in the treatment of biliary complications after liver transplantation in the era of nonsurgical therapies. Liver Transpl. 6, 201–206 (2000).

    CAS  PubMed  Google Scholar 

  7. Bismuth, H. Postoperative strictures of the bile duct. in The Biliary Tract (ed. Blumgart, L. H.) 209–218 (Churchill Livingstone, Edinburgh, 1982).

    Google Scholar 

  8. Strasberg, S. M., Hertl, M. & Soper, N. J. An analysis of the problem of biliary injury during laparoscopic cholecystectomy. J. Am. Coll. Surg. 180, 101–125 (1995).

    CAS  PubMed  Google Scholar 

  9. Costamagna, G. et al. Long-term results of endoscopic management of post-operative bile duct strictures with increasing number of stents. Gastrointest. Endosc. 54, 162–168 (2001).

    CAS  PubMed  Google Scholar 

  10. Draganov, P. et al. Long-term outcome in patients with benign biliary strictures treated endoscopically with multiple stents. Gastrointest. Endosc. 55, 680–686 (2002).

    PubMed  Google Scholar 

  11. Matlock, J. & Freeman, M. L. Endoscopic therapy of benign biliary strictures. Rev. Gastroenterol. Disord. 5, 206–214 (2005).

    PubMed  Google Scholar 

  12. Zoepf, T. et al. Balloon dilatation vs balloon dilatation plus bile duct endoprostheses for treatment of anastomotic biliary strictures after liver transplantation. Liver Transpl. 12, 88–94 (2006).

    PubMed  Google Scholar 

  13. Thuluvath, P. J. et al. Biliary complications after liver transplantation: the role of endoscopy. Endoscopy 37, 857–863 (2005).

    CAS  PubMed  Google Scholar 

  14. Lawrence, C. et al. Low symptomatic premature stent occlusion of multiple plastic stents for benign biliary strictures: comparing standard and prolonged stent change intervals. Gastrointest. Endosc. 72, 558–563 (2010).

    PubMed  Google Scholar 

  15. Costamagna, G. et al. Multidisciplinary approach to benign biliary strictures. Curr. Treat. Options Gastroenterol. 10, 90–101 (2007).

    PubMed  Google Scholar 

  16. Baron, T. H. & Morgan, D. E. Dilation of a difficult benign pancreatic duct stricture using the Soehendra stent extractor. Gastrointest. Endosc. 46, 178–180 (1997).

    CAS  PubMed  Google Scholar 

  17. Ziebert, J. J. & DiSario, J. A. Dilation of refractory pancreatic duct strictures: the turn of the screw. Gastrointest. Endosc. 49, 632–635 (1999).

    CAS  PubMed  Google Scholar 

  18. Fazel, A. et al. Navigating the hilum: utility of a steerable catheter for selective cannulation of the intrahepatic bile ducts [abstract]. Gastrointest. Endosc. 61, AB204 (2005).

    Google Scholar 

  19. Baron, T. H. & Poterucha, J. J. Use of a small-caliber angioplasty balloon for the management of an impassable choledochocholedochal anastomotic biliary stricture. Liver Transpl. 14, 1683–1684 (2008).

    PubMed  Google Scholar 

  20. Huibregste, K., Katon, R. M. & Tytgat, G. N. Endoscopic treatment of post-operative biliary strictures. Endoscopy 18, 133–137 (1986).

    Google Scholar 

  21. Geenen, D. J. et al. Endoscopic therapy for benign bile duct strictures. Gastrointest. Endosc. 35, 367–371 (1989).

    CAS  PubMed  Google Scholar 

  22. Davis, P. H. et al. Endoscopic stenting for post-operative biliary strictures. Gastrointest. Endosc. 38, 12–18 (1992).

    Google Scholar 

  23. Kassab, C. et al. Endoscopic management of post-laparoscopic cholecystectomy biliary strictures. Long-term outcome in a multicenter study. Gastroenterol. Clin. Biol. 30, 124–129 (2006).

    PubMed  Google Scholar 

  24. Pozsar, J. et al. Endoscopic treatment of sphincterotomy-associated distal common bile duct strictures by using sequential insertion of multiple plastic stents. Gastrointest. Endosc. 62, 85–91 (2005).

    PubMed  Google Scholar 

  25. Costamagna, G. et al. Endotherapy of postoperative biliary strictures with multiple stents: results after more than 10 years of follow-up. Gastrointest. Endosc. 72, 551–557 (2010).

    PubMed  Google Scholar 

  26. Thuluvath, P. J., Atassi, T. & Lee, J. An endoscopic approach to biliary complications following orthotopic liver transplantation. Liver Int. 23, 156–162 (2003).

    PubMed  Google Scholar 

  27. Wojcicki, M., Milkiewickz, P. & Silva, M. Biliary tract complications after liver transplantation: a review. Dig. Surg. 25, 245–257 (2008).

    PubMed  Google Scholar 

  28. Welling, T. H. et al. Biliary complications following liver transplantation in the model for end-stage liver disease era: effect of donor, recipient, and technical factors. Liver Transpl. 14, 73–80 (2008).

    PubMed  Google Scholar 

  29. Koneru, B. et al. Bile duct strictures after liver transplantation: a changing landscape of the Achille's heel. Liver Transpl. 12, 702–704 (2006).

    PubMed  Google Scholar 

  30. Sanchez-Urdazpal, L. et al. Diagnostic features and clinical outcome of ischemic-type biliary complications after liver transplantation. Hepatology 17, 605–609 (1993).

    CAS  PubMed  Google Scholar 

  31. Pasha, S. F. et al. Endoscopic treatment of anastomotic biliary strictures after deceased donor liver transplantation: outcomes after maximal stent therapy. Gastrointest. Endosc. 66, 44–51 (2007).

    PubMed  Google Scholar 

  32. Thethy, S. et al. Management of biliary tract complications after orthotopic liver transplantation. Clin. Transplant. 18, 647–653 (2004).

    PubMed  Google Scholar 

  33. Verdonk, R. C. et al. Anastomotic biliary strictures after liver transplantation: causes and consequences. Liver Transpl. 12, 726–735 (2006).

    PubMed  Google Scholar 

  34. Schwartz, D. A. et al. Endoscopic therapy of anastomotic bile duct strictures ocurring after liver transplantation. Gastrointest. Endosc. 51, 169–174 (2000).

    CAS  PubMed  Google Scholar 

  35. Graziadei, I. W. et al. Long-term outcome of endoscopic treatment of biliary strictures after liver transplantation. Liver Transpl. 12, 718–725 (2006).

    PubMed  Google Scholar 

  36. Morelli, J. et al. Long-term outcomes for patients with post-liver transplant anastomotic biliary strictures treated by endoscopic stent placement. Gastrointest. Endosc. 58, 374–379 (2003).

    PubMed  Google Scholar 

  37. Holt, A. P. et al. A prospective study of standardized nonsurgical therapy in the management of biliary anastomotic strictures complicating liver transplantation. Transplantation 84, 857–863 (2007).

    PubMed  Google Scholar 

  38. Kulaksiz, H. et al. Is stenting necessary after balloon dilation of post-transplantation biliary strictures? Results of a prospective comparative study. Endoscopy 40, 746–751 (2008).

    CAS  PubMed  Google Scholar 

  39. Alazmi, W. M. et al. Recurrence rate of anastomotic billiary strictures in patients who have had previous successful endoscopic therapy for anastomotic narrowing after orthotopic liver transplantation. Endoscopy 38, 571–574 (2006).

    CAS  PubMed  Google Scholar 

  40. Pfau, P. R. et al. Endoscopic management of postoperative biliary complications in orthotopic liver transplantation. Gastrointest. Endosc. 52, 55–63 (2000).

    CAS  PubMed  Google Scholar 

  41. Tabibian, J. et al. Endoscopic treatment with multiple stents for post-liver transplantation non-anastomotic biliary strictures. Gastrointest. Endosc. 69, 1236–1243 (2009).

    PubMed  Google Scholar 

  42. Buis, C. I. et al. Causes and consequences of ischemic-type biliary lesions after liver transplantation. J. Hepatobiliary Pancreat. Surg. 13, 517–524 (2006).

    PubMed  Google Scholar 

  43. Sawyer, R. G. & Punch, J. D. Incidence and management of biliary complications after 291 liver transplants following the introduction of transcystic stenting. Transplantation 66, 1201–1207 (1998).

    CAS  PubMed  Google Scholar 

  44. Rerknimitr, R. et al. Biliary tract complications after orthotopic liver transplantation with choledocho-choledochostomy anastomosis: endoscopic findings and results of therapy. Gastrointest. Endosc. 55, 224–231 (2002).

    PubMed  Google Scholar 

  45. Rizk, R. S. et al. Endoscopic management of biliary strictures in liver transplant recipients: effect on patient and graft survival. Gastrointest. Endosc. 47, 128–135 (1998).

    CAS  PubMed  Google Scholar 

  46. Guichelaar, M. M. et al. Risk factors for and clinical course of non-anastomotic biliary strictures after liver transplantation. Am. J. Transplant. 3, 885–890 (2003).

    PubMed  Google Scholar 

  47. Jagannath, S. & Kalloo, A. N. Biliary complications after liver transplantation. Curr. Treat. Options Gastroenterol. 5, 101–112 (2002).

    PubMed  Google Scholar 

  48. Tung, B. Y. & Kimmey, M. B. Biliary complications of orthotopic liver transplantation. Dig. Dis. 17, 133–144 (1999).

    CAS  PubMed  Google Scholar 

  49. Wilson, C. et al. Hepatobiliary complications in chronic pancreatitis. Gut 30, 520–527 (1989).

    CAS  PubMed  PubMed Central  Google Scholar 

  50. Deviere, J. et al. Endoscopic biliary drainage in chronic pancreatitis. Gastrointest. Endosc. 36, 96–100 (1990).

    CAS  PubMed  Google Scholar 

  51. Smits, M. E. et al. Long-term results of endoscopic stenting and surgical drainage for biliary stricture due to chronic pancreatitis. Br. J. Surg. 83, 764–768 (1996).

    CAS  PubMed  Google Scholar 

  52. Kahl, S. et al. Risk factors for failure of endoscopic stenting of biliary strictures in chronic pancreatitis: a prospective follow-up study. Am. J. Gastroenterol. 98, 2448–2453 (2003).

    PubMed  Google Scholar 

  53. Barthet, M. et al. Biliary stenting in benign biliary stenosis complicating chronic calcifying pancreatitis. Endoscopy 26, 569–572 (1994).

    CAS  PubMed  Google Scholar 

  54. Kiehne, K., Folsch, U. R. & Nitsche, R. High complication rate of bile duct stents in patients with chronic alcoholic pancreatitis due to noncompliance. Endoscopy 32, 377–380 (2000).

    CAS  PubMed  Google Scholar 

  55. Vitale, G. C. et al. Endoscopic treatment of distal bile duct stricture from chronic pancreatitis. Surg. Endosc. 14, 227–231 (2000).

    CAS  PubMed  Google Scholar 

  56. Farnbacher, M. J. et al. Is endoscopic drainage of common bile duct stenosis in chronic pancreatitis up-to-date? Am. J. Gastroenterol. 95, 1466–1471 (2000).

    CAS  PubMed  Google Scholar 

  57. Eickhoff, A. et al. Endoscopic stenting for common bile duct stenoses in chronic pancreatitis: results and impact on long-term outcome. Eur. J. Gastroenterol. Hepatol. 13, 1161–1167 (2001).

    CAS  PubMed  Google Scholar 

  58. Catalano, M. F. et al. Treatment of symptomatic distal common bile duct stenosis secondary to chronic pancreatitis: comparison of single vs multiple simultaneous stents. Gastrointest. Endosc. 60, 945–952 (2004).

    PubMed  Google Scholar 

  59. Pozsar, J. et al. Medium-term results of endoscopic treatment of common bile duct strictures in chronic calcifying pancreatitis with increased number of stents. J. Clin. Gastroenterol. 38, 118–123 (2004).

    PubMed  Google Scholar 

  60. Wiesner, R. H. & LaRusso, N. F. Clinicopathologic features of the syndrome of primary sclerosing cholangitis. Gastroenterology 79, 200–206 (1980).

    CAS  PubMed  Google Scholar 

  61. Tischendorf, J. J. et al. Characterization, outcome and prognosis in 273 patients with primary sclerosing cholangitis: a single center study. Am. J. Gastroenterol. 102, 107–114 (2007).

    PubMed  Google Scholar 

  62. Stiehl, A. et al. Development of dominant bile duct stenoses in patients with primary sclerosing cholangitis treated with ursodeoxycholic acid: outcome after endoscopic treatment. J. Hepatol. 36, 151–156 (2002).

    PubMed  Google Scholar 

  63. Björnsson, E. et al. Dominant strictures in patients with primary sclerosing cholangitis. Am. J. Gastroenterol. 99, 2281 (2004).

    PubMed  Google Scholar 

  64. Kaya, M. et al. Balloon dilation compared with stenting of dominant strictures in primary sclerosing colangitis. Am. J. Gastroenterol. 96, 1059–1066 (2001).

    CAS  PubMed  Google Scholar 

  65. Linder, S. & Soderlund, C. Endoscopic therapy in primary sclerosing cholangitis: outcome of treatment and risk of cancer. Hepatogastroenterology 48, 387–392 (2001).

    CAS  PubMed  Google Scholar 

  66. van Milligen de Wit, A. W. et al. Endoscopic stent therapy for dominant extrahepatic bile duct strictures in primary sclerosing colangitis. Gastrointest. Endosc. 44, 293–299 (1996).

    CAS  PubMed  Google Scholar 

  67. Stiehl, A. et al. Efficacy of ursodeoxycholic acid treatment and endoscopic dilation of major duct stenoses in primary sclerosing cholangitis. An 8-year prospective study. J. Hepatol. 26, 560–566 (1997).

    CAS  PubMed  Google Scholar 

  68. Baluyut, A. R. et al. Impact of endoscopic therapy on the survival of patients with primary sclerosing cholangitis. Gastrointest. Endosc. 53, 308–312 (2001).

    CAS  PubMed  Google Scholar 

  69. Gluck, M. et al. A twenty-year experience with endoscopic therapy for symptomatic primary sclerosing cholangitis. J. Clin. Gastroenterol. 42, 1032–1039 (2008).

    PubMed  Google Scholar 

  70. Ponsioen, C. Y. et al. Four years experiences with short term stenting in primary sclerosing colangitis. Am. J. Gastroenterol. 94, 2403–2407 (1999).

    CAS  PubMed  Google Scholar 

  71. Bangarulingam, S. et al. Complications of endoscopic retrograde cholangiopancreatography in primary sclerosing cholangitis. Am. J. Gastroenterol. 104, 855–860 (2009).

    PubMed  Google Scholar 

  72. Chari, S. T. Current concepts in the treatment of autoimmune pancreatitis. JOP 8, 1–3 (2007).

    PubMed  Google Scholar 

  73. Chari, S. T. et al. Diagnosis of autoimmune pancreatitis: The Mayo Clinic Experience. Clin. Gastroenterol. Hepatol 4, 1010–1016 (2006).

    PubMed  Google Scholar 

  74. Zen, Y. et al. IgG4-related sclerosing colangitis with and without hepatic inflammatory pseudotumor, and sclerosing pancreatitis-associated sclerosing colangitis: do they belong to a spectrum of sclerosing pancreatitis? Am. J. Surg. Pathol. 28, 1193–1203 (2004).

    PubMed  Google Scholar 

  75. Björnsson, E. et al. Immunoglobulin G4 associated cholangitis: description of an emerging clinical entity based on review of the literature. Hepatology 45, 1547–1554 (2007).

    PubMed  Google Scholar 

  76. Small, A. J. et al. A case of IgG4-associated cholangitis and autoimmune pancreatitis responsive to corticosteroids. Nat. Clin. Pract. Gastroenterol. Hepatol. 5, 707–712 (2008).

    PubMed  Google Scholar 

  77. Foerster, E. C., Hoepffner, N. & Domschke, W. Bridging of benign choledocal stenoses by endoscopic retrograde implantation of mesh stents. Endoscopy 23, 133–135 (1991).

    CAS  PubMed  Google Scholar 

  78. O'Brien, S. M. et al. A 5-year follow-up of self-expanding metal stents in the endoscopic management of patients with benign bile duct strictures. Eur. J. Gastroenterol. Hepatol. 10, 141–145 (1998).

    CAS  PubMed  Google Scholar 

  79. Roumilhac, D. et al. Long-term results of percutaneous management for anastomotic biliary stricture after orthotopic liver transplantation. Liver Transpl. 9, 394–400 (2003).

    PubMed  Google Scholar 

  80. Deviere, J. et al. Management of common bile duct stricture caused by chronic pancreatitis with metal mesh self expandable stents. Gut 35, 122–126 (1994).

    CAS  PubMed  PubMed Central  Google Scholar 

  81. van Berkel, A. M. et al. Self-expanding metal stents in benign biliary strictures due to chronic pancreatitis. Endoscopy 36, 381–384 (2004).

    CAS  PubMed  Google Scholar 

  82. Yamaguchi, T. et al. Long-term outcome of endoscopic metallic stenting for benign biliary stenosis associated with chronic pancreatitis. World J. Gastroenterol. 12, 426–430 (2006).

    PubMed  PubMed Central  Google Scholar 

  83. Eickhoff, A. et al. Self-expandable metal mesh stents for common bile duct stenosis in chronic pancreatitis: retrospective evaluation of long-term follow-up and clinical outcome pilot study. Z. Gastroenterol. 41, 649–654 (2003).

    CAS  PubMed  Google Scholar 

  84. Kahl, S. et al. Treatment of benign biliary strictures in chronic pancreatitis by self-expandable metal stents. Dig. Dis. 20, 199–203 (2002).

    PubMed  Google Scholar 

  85. Kahaleh, M. et al. Removal of self-expandable metallic Wallstents. Gastrointest. Endosc. 60, 640–644 (2004).

    PubMed  Google Scholar 

  86. van Boeckel, P., Vleggaar, F. P. & Siersema, P. Plastic or metal stents for benign extrahepatic biliary strictures: a systematic review. BCM Gastroenterology 9, 96 (2009).

    Google Scholar 

  87. Behm, B. et al. Partially covered self-expandable metallic stents for benign biliary strictures due to chronic pancreatitis. Endoscopy 41, 547–551 (2009).

    CAS  PubMed  Google Scholar 

  88. Chaput, U. et al. Temporary placement of partially covered self-expandable metal stents for anastomotic biliary strictures after liver transplantation: a prospective multicenter study. Gastrointest. Endosc. 72, 1167–1174 (2010).

    PubMed  Google Scholar 

  89. Kahaleh, M. et al. Temporary placement of covered self-expandable metal stents in benign biliary strictures: a new paradigm? Gastrointest. Endosc. 67, 446–454 (2008).

    PubMed  Google Scholar 

  90. Bruno, M. et al. Use of removable covered expandable metals stents (RCEMS) in the treatment of benign distal common duct (CBD) strictures: a feasibility study [abstract]. Gastrointest. Endosc. 61, AB199 (2005).

    Google Scholar 

  91. Kuo, M. D. et al. Intentional retrieval of Viabil stent-graft from the biliary system. J. Vasc. Interv. Radiol. 17, 389–397 (2006).

    PubMed  Google Scholar 

  92. Cahen, D. L. et al. Long-term results of endoscopic drainage of common bile duct strictures in chronic pancreatitis. Eur. J. Gastroenterol. Hepatol. 17, 103–108 (2005).

    PubMed  Google Scholar 

  93. Traina, M. et al. Efficacy and safety of fully covered self-expandable metallic stents in biliary complications after liver transplantation: a preliminary study. Liver Transpl. 15, 1493–1498 (2009).

    PubMed  Google Scholar 

  94. Mahajan, A. et al. Temporary placement of fully covered self-expandable metal stents in benign biliary strictures: midterm evaluation. Gastrointest. Endosc. 70, 303–309 (2009).

    PubMed  Google Scholar 

  95. Park, D. H. et al. Anchoring flap versus flare end, fully covered self-expandable metal stents to prevent migration in patients with benign biliary strictures: a multicenter, prospective, comparative pilot study. Gastrointest. Endosc. 73, 64–70 (2011).

    PubMed  Google Scholar 

  96. Hu, B. et al. Endoscopic stenting for post-transplant biliary stricture: usefulness of a novel removable covered metal stent. J. Hepatobiliary Pancreat. Sci. 18, 640–645 (2011).

    PubMed  Google Scholar 

  97. Saleem, A. et al. Endoscopic retrograde cholangiopancreatography using a single-balloon enteroscope in patients with altered Roux-en-Y anatomy. Endoscopy 42, 656–660 (2010).

    CAS  PubMed  Google Scholar 

  98. Raithel, M. et al. Double-balloon-enteroscopy-based endoscopic retrograde cholangiopancreatography in post-surgical patients. World J. Gastroenterol. 17, 2302–2314 (2011).

    PubMed  PubMed Central  Google Scholar 

  99. Wang, A. Y. et al. Single-balloon enteroscopy effectively enables diagnostic and therapeutic retrograde cholangiography in patients with surgically altered anatomy. Gastrointest. Endosc. 71, 641–649 (2010).

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Contributions

Both authors contributed equally to all aspects of the article.

Corresponding author

Correspondence to Todd H. Baron.

Ethics declarations

Competing interests

The authors declare no competing financial interests.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Zepeda-Gómez, S., Baron, T. Benign biliary strictures: current endoscopic management. Nat Rev Gastroenterol Hepatol 8, 573–581 (2011). https://doi.org/10.1038/nrgastro.2011.154

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/nrgastro.2011.154

This article is cited by

Search

Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing