Predictors of success of treatment of distal two thirds common bile duct strictures: A retrospective Cohort study over two years

• Distal biliary strictures have a multifactorial etiology.
• Pancreatic adenocarcinoma was the most common cause followed by fibrotic stricture secondary to stones.
• Patients were classified according to the intervention into (endoscopy, open surgery, percutaneous and follow up) groups.
• In univariate analysis, the success of treatment was significantly associated with the benign nature of the stricture of CBD.
• This is the first report to address this issue focusing on the distal location of the strictures no matter the etiology.

BackgroundDistal biliary stricture is a challenging clinical condition that requires a co-ordinated multidisciplinary approach.The aim of this workwas to evaluate the predictors of success of different treatment modalities of distal two thirds CBD strictures.Patients and methodsData were retrieved retrospectively from the medical records of the patients with distal biliary strictures treated in the Main Alexandria University Hospital from June 2013 to June 2015. Patients were classified into three groups according to the intervention performed: (endoscopic, open surgical, and percutaneous). In addition to the forth group that was followed up without intervention.ResultsThe study included 282 patients. The mean age was 61.1 ± 10.8 years (25–78) years. The most frequent presenting symptom was jaundice. Pancreatic adenocarcinoma was the most common cause followed by fibrotic stricture secondary to stones.ConclusionIn univariate analysis, the success of treatment was significantly associated with the pathology of the stricture of the distal two thirds CBD. In the multivariate analysis, only two factors were affecting the success of the treatment; the stricture length and site.