ArticleGastro hep advances2026
Twelve-month Results From the Percutaneous Endoscopic Benign Biliary Laser Stricturotomy Study: A Prospective Single-Arm Pilot Trial Evaluating Safety and Efficacy.
Article in Gastro hep advances, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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6 authors.
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Abstract
Background and Aims: Benign biliary strictures (BBSs) are associated with poor long-term patency, substantial morbidity, and high health-care costs. Despite a multitude of available treatment options-peroral endoscopic, percutaneous transhepatic, and surgical reconstruction-recurrence rates remain high. This study assesses the safety and efficacy of percutaneous transhepatic cholangioscopy (PTCS)-assisted holmium laser stricturotomy for BBS management. Methods: The Percutaneous Endoscopic Benign Biliary Laser study is a prospective, single-arm, open-label pilot trial conducted at a single academic institution. Between October 2022 and August 2023, 5 patients with BBSs underwent PTCS-assisted laser stricturotomy, with or without lithotripsy, using a holmium:yttrium-aluminum-garnet laser fiber. Patients were followed for 12 months. Primary endpoints included technical success and 30-day adverse events, while secondary endpoints assessed 12-month primary patency (freedom from stricture recurrence) and cumulative device-free survival. Data were gathered through imaging (magnetic resonance cholangiopancreatography or CT), clinical visits, and laboratory tests at 3, 6, and 12 months. Results: Technical success was achieved in 100% of cases, with all patients experiencing stricture resolution and biliary drain removal. Primary biliary patency was 80% (4 of 5), with 1 patient experiencing asymptomatic stricture recurrence and undergoing metallic stenting, remaining drain-free thereafter. Cumulative device-free survival averaged 9.4 ± 4.8 months. Three 30-day adverse events were noted in 2 patients: self-limited hemobilia, a bile leak, and a tract site infection. Conclusion: PTCS-assisted holmium laser stricturotomy is a promising new treatment for benign biliary strictures, offering durable tube-free 12-month patency with an acceptable safety profile. The Percutaneous Endoscopic Benign Biliary Laser study provides a foundation for future clinical research to build upon and suggests that this emerging approach could augment traditional, less effective stenting protocols.
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