Postoperative biliary stricture

Postoperative biliary stricture is a cumbersome condition secondary to biliary or vascular damage. Its risk factors include biliary or vascular anatomical variants, local inflammation, and poor surgical expertise. Intraoperative diagnosis is difficult, and in most cases, patients present with obstructive symptoms within a few weeks. Magnetic resonance cholangiography is a pivotal test to confirm the clinical picture, to study the level of the damage, and to guide treatment. Nowadays, endoscopic stenting is the first-line treatment in most centers. Radiological and surgical approaches are considered in case of endoscopy failure. Multi-stenting treatment achieves long-term clinical success for more than 90% of patients, but multiple procedures are needed. In order to optimize healthcare provider costs, shorter-duration endotherapies with covered metal stents are under evaluation.