How to Manage Biliary Strictures

The doctors first break down the signs and clinical picture that alert them to a possible biliary stricture. Dr. Trivedi then explains the steps of his workup and preferred imaging, and also describes his threshold to pursue percutaneous transhepatic cholangiography (PTC), especially in diffuse conditions like primary sclerosing cholangitis. Dr. Trivedi also walks through his procedural steps for PTC and drain placement, covering his best practices and typical intraoperative decision making.

Dr. Trivedi then explains the role of angioplasty over the course of longitudinal treatment, balloon choice, and his upper limit of catheter upsizing. The doctors also delve into the role of interventional endoscopy and tackling complications such as bleeding and tube leakage. The conversation offers valuable insights for trainees and practitioners alike, and highlights future advancements in biliary interventions.