ERCP for biliary strictures associated with chronic pancreatitis

Gastrointest Endosc Clin N Am. 2013 Oct;23(4):833-45. doi: 10.1016/j.giec.2013.06.007. Epub 2013 Jul 24.

Abstract

Chronic pancreatitis (CP)-related common bile duct (CBD) strictures are more difficult to treat endoscopically compared with benign biliary strictures because of their nature, particularly in patients with calcific CP. Before any attempt at treatment, malignancy must be excluded. Single plastic stents can be used for immediate symptom relief and as "bridge to surgery and/or bridge to decision," but are not suitable for definitive treatment of CP-related CBD strictures because of long-term poor results. Temporary simultaneous placement of multiple plastic stents has a high technical success rate and provides good long-term results.

Keywords: Benign biliary strictures; Chronic pancreatitis; Dilation; ERCP; Pancreatic cancer; Plastic stent; Self-expandable metal stent; Surgery.

Publication types

  • Review

MeSH terms

  • Cholangiopancreatography, Endoscopic Retrograde*
  • Common Bile Duct Diseases / diagnosis
  • Common Bile Duct Diseases / etiology*
  • Common Bile Duct Diseases / surgery*
  • Constriction, Pathologic / diagnosis
  • Constriction, Pathologic / etiology
  • Constriction, Pathologic / surgery
  • Drainage
  • Fibrosis / complications
  • Humans
  • Pancreas / pathology*
  • Pancreatitis, Chronic / complications*
  • Stents