BILLIARY STRICTURE

benign:

postoperative (commonly laparoscopic cholecystectomy) [80%]

chronic pancreatitis [10%]

acute pancreatitis

pancreatic pseudocyst or abscess

primary sclerosing cholangitis

choledocholithiasis

cholangitis (stones or other causes)

post-ERCP (with sphincterotomy)

HIV cholangiopathy (usually infective & due to CMV or Cryptosporidium)

post-liver transplant (various factors, including surgical trauma, infection, rejection, ischaemia-reperfusion injury)

Mirizzi syndrome

radiation

blunt abdominal trauma

connective tissue disease / vasculitis (PAN, SLE)

infection (including TB, Histoplasmosis)

chemotherapy (especially hepatic artery infusion)

choledochal cyst

duodenal diverticulum

recurrent pyogenic cholangitis (‘Oriental cholangiohepatitis’)

Crohn’s disease

hepatic artery aneurysm

cystic fibrosis with liver involvement

eosinophilic cholecystitis

idiopathic

malignant:

pancreatic adenocarcinoma

mucinous cystadenocarcinoma

ampullary carcinoma

cholangiocarcinoma

gall-bladder carcinoma

hepatocellular cancer

metastases or lymphoma at porta hepatis