Hilar strictures - clear management strategies start to emerge.

The management of hilar strictures has continued to be a challenge for endoscopists. There is little consensus in the literature and a host of other variables to consider investigations and management that often serve to add confusion rather than resolution to the issue. A number of different management strategies have been instituted but none of them have had stellar results. This disease, like many palliative situations in gastroenterology, is fraught with difficulty, often ending in the ungratifying end point of death within weeks of a successful procedure.