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Patient care — surgical procedures

Bilary (bile duct) strictures: Endoscopic (using a tube called an endoscope through a small incision) or percutaneous (through the skin) dilation of the stricture can be used, depending on the location of the stricture.

The objective of surgical therapy is to re-establish the flow of bile from the liver into the intestine. Depending on the location, the stricture may be surgically removed and the biliary duct rejoined with the small intestine or the hepatic duct.

For some patients, a biliary stent is placed across the bile duct stricture to keep it open.

Bilary (bile duct) stricture dilation: ERCP is used dilation of strictures (e.g. primary sclerosing cholangitis, anastomotic strictures after liver transplantation).

Bile duct strictures may be asymptomatic but, if ignored, can cause life-threatening complications, such as ascending cholangitis, liver abscess, and secondary biliary cirrhosis. However, not all strictures are benign. Pancreatic cancer is the most common cause of malignant biliary strictures.

The combination of sphincterotomy and endoscopic balloon dilation alone is not a reliable method of treating benign strictures.

Dilation followed by short- to intermediate-term stent placement appears to provide a more durable result.

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