In the last 10 years 44 patients with malignant stricture and 37 patie
nts with benign stricture were diagnosed and managed in our unit. For
both types of strictures we applied either a surgical, endoscopic or c
ombined approach for managing these patients. In two patients with ben
ign biliary stricture we performed endoscopic dilatations and/or singl
e or double stenting repeatedly and despite performing the procedure (
five times In one and 11 times in the other) and with the use of 7 or
10 French plastic stents, the outcome was disappointing and strictures
were refractory to dilatation and long-term stenting. in these two ca
ses we inserted large lumen metal stents with excellent outcome and no
recurrence of cholangitis or any cholestasis. To our knowledge this w
as the first report on the use of metal stents in benign biliary stric
tures in Saudi Arabia.