What treatment would you offer a patient who underwent surgery for an extrahepatic cholangiocarcinoma and subsequently developed an isolated malignant biliary stricture?

In this case, for an isolated bile duct recurrence, local radiation therapy can be considered. It would be preferred over systemic therapy as radiation therapy can provide long term disease control. The case would have to be discussed with the radiation oncologist regarding feasibility and type and ...

Radiation is a good option but that duct is certainly going to scar down afterwards. I would suggest biliary stenting pre-emptively. Stents shouldn’t be metal during radiation but could be switched out afterwards.