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Benign biliary strictures associated with acute biliary pancreatitis

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Abstract

Background and aims

There are limited data about the benign biliary strictures (BBS) which can develop during the clinical course of acute biliary pancreatitis (ABP) due to compression of the common bile duct (CBD) by edematous and inflamed pancreatic tissue. We aimed to determine the incidence of BBS due to ABP and its clinical course after endoscopic management.

Methods

The study was retrospectively conducted among patients with ABP who were admitted to a single tertiary reference center during 3 years. BBS-ABP was defined as distal narrowing of the CBD with proximal dilatation and delayed drainage of the contrast into the duodenum. Endoscopic treatment was performed by inserting a single 7F or 10F plastic stent which was exchanged every 3 months until stricture resolution. Patients were followed for 1 year after stricture resolution.

Results

Seven hundred and twenty-one patients had ABP during the study period. Among them, 257 (35.6%) patients underwent ERCP and 26 patients (3.6%) had CBD stricture due to ABP. A 7 Fr plastic stent was inserted in 18 patients and 10 Fr in 8 patients. The stricture was completely resolved at 3 months in 66.7%, at 6 months 23.8% and at 9 months (9.5%) of the patients. There was no procedure-related complications other than asymptomatic stent migration in 4 (19%) patients. None of the patients had recurrent biliary stricture during the 1 year stent-free follow-up period.

Conclusion

BBS-ABP is a frequently seen clinical entity. In most patients, the stricture improves within 3 months and temporary endoscopic stenting prevents the patients from the consequences of the obstruction during this period.

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Abbreviations

ABP:

Acute biliary pancreatitis

AIP:

Autoimmune pancreatitis

ARFI:

Acoustic Radiation Force Impulse

BBS-ABP:

Benign biliary strictures associated with acute biliary pancreatitis,

CBD:

Common bile duct

CP:

Chronic pancreatitis

CT:

Computed tomography

ERCP:

Endoscopic retrograde cholangiopancreatography

EUS:

Endoscopic ultrasonography

FC-SEMS:

Fully covered self-expandable metal stent

MRCP:

Magnetic resonance cholangiopancreatography

PP:

Pancreatic pseudocyst

PTC:

Percutaneous transhepatic cholangiography

SWV:

Shear wave velocity

SPSS:

Statistical Package for Social Sciences

WON:

Walled-off necrosis

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Authors and Affiliations

  1. Faculty of Medicine, Department of Gastroenterology, Korucuk Campus, Sakarya University, Sakarya, Turkey

    Ahmet Tarik Eminler, Aydin Seref Koksal, Bilal Toka & Mustafa İhsan Uslan

  2. Sakarya Training and Research Hospital, Gastroenterology, Sakarya, Turkey

    Cengiz Karacaer

  3. Faculty of Medicine, Department of Gastroenterology, Hacettepe University, Ankara, Turkey

    Erkan Parlak

Authors
  1. Ahmet Tarik Eminler
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  2. Aydin Seref Koksal
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  3. Bilal Toka
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  5. Mustafa İhsan Uslan
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Correspondence to Ahmet Tarik Eminler.

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Dr Ahmet Tarık Eminler, Dr Aydin Seref Koksal, Dr Bilal Toka, Dr Cengiz Karacaer, Dr Mustafa Ihsan Uslan, and Dr Erkan Parlak have no conflicts of interest or financial ties to disclose.

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Eminler, A.T., Koksal, A.S., Toka, B. et al. Benign biliary strictures associated with acute biliary pancreatitis. Surg Endosc 37, 2587–2594 (2023). https://doi.org/10.1007/s00464-022-09753-2

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  • DOI: https://doi.org/10.1007/s00464-022-09753-2

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