SIR 2026

Educational Exhibit

Nonvascular Interventions

Biliary

Session: Educational Exhibit Presentations - Portal hypertension/Transplant/GI

788 - Advanced Percutaneous Management of Benign Biliary Stricture Using Covered Biliary Stents, Endobiliary Radiofrequency Ablation, and Holmium Laser Ablation

Monday, April 13, 2026

5:33 PM - 5:39 PM ET

Abstract Presenter(s)

rC

rihin Chavda, MD

Resident
Interventional Radiology, UT Southwestern Medical Center, United States

Author/Co-author(s)

AS

Akram Sadeghi, MD

Assistant Professor
Interventional Radiology, UT Southwestern Medical Center, United States
SK

Seung K. Kim, MD, FSIR, MBA

Professor
Interventional Radiology, UT Southwestern Medical Center, United States

Learning Objectives:

To understand the common causes and anatomical locations of benign biliary strictures

To review advanced percutaneous treatment options for benign biliary strictures

To learn the treatment algorithms used in advanced percutaneous management of biliary strictures

Background: Benign biliary strictures can arise from a variety of conditions, including chronic pancreatitis, bile duct injury, previous biliary surgeries (such as liver transplantation), and infections like cholangitis. The primary goal of percutaneous management is to restore effective bile drainage and prevent complications such as cholangitis and liver damage.
This exhibit highlights advanced percutaneous techniques in the management of benign biliary strictures, including the use of covered biliary stents, endobiliary radiofrequency (RF) ablation, and Holmium laser ablation.

Clinical Findings/Procedure Details:

Etiologies of benign biliary stricture:

Chronic pancreatitis

Iatrogenic bile duct injury

Postoperative strictures (e.g., following liver transplantation or cholecystectomy)

Infectious causes such as recurrent cholangitis

Common anatomical locations of strictures:

Intrahepatic bile ducts

Distal common bile duct (CBD)

Surgical anastomosis sites:

Hepaticojejunostomy

Choledochojejunostomy

Choledocho-choledochostomy

Covered biliary stents:

Advantages: Maintains duct patency, removable, and useful for longer strictures

Disadvantages: Risk of migration, occlusion, and tissue overgrowth

Endobiliary radiofrequency (RF) ablation:

Advantages: Minimally invasive, useful for fibrotic strictures, promotes tissue remodeling

Disadvantages: Potential for thermal injury, requires specialized equipment

Endobiliary Holmium laser ablation:

Advantages: Precise tissue ablation, less collateral damage, useful in resistant or dense strictures

Disadvantages: Limited availability, requires expertise and laser safety protocols

Treatment algorithms:

Stepwise approach involving diagnostic imaging, biliary drainage, stricture characterization, followed by selection of appropriate advanced intervention based on location, cause, and response to prior treatment

Conclusion and/or Teaching Points: Advanced percutaneous techniques—such as covered stent placement, RF ablation, and Holmium laser ablation—offer effective alternatives in the management of benign biliary strictures. These methods can facilitate earlier biliary drain removal and provide excellent long-term ductal patency, especially in complex or recurrent cases.