VASCULAR-INTERVENTIONAL Absorbable stents for treatment of benign biliary strictures: long-term follow-up in the prospective Spanish registry Miguel A. De Gregorio 1 & Eva Criado 2 & Jose A. Guirola 1 & Enrique Alvarez-Arranz 1 & Mercedes Pérez-Lafuente 3 & Marta Barrufet 4 & Maria D. Ferrer-Puchol 5 & Sandra Lopez-Minguez 1 & Jose Urbano 6 & Carlos Lanciego 7 & Alexander Aguinaga 8 & Antonio Capel 9 & Maria D. Ponce-Dorrego 10 & Abel Gregorio 11 & Spanish group BiELLA (SERVEI) Received: 11 February 2020 /Revised: 1 March 2020 /Accepted: 9 March 2020 # European Society of Radiology 2020 Abstract Objectives Benign strictures of the bile duct may be difficult to treat endoscopically due to altered bowel anatomy. Furthermore, recurrence of stenosis and symptoms remains high. The aim of the Spanish Prospective Registry BiELLA study was to inves- tigate the safety and efficacy of absorbable stents in the treatment of benign biliary strictures and their outcomes on the medium and long-term follow-up. Methods A prospective, multicenter, observational, non-randomized study (the BiELLA study) was conducted from January 2014 to September 2018. One hundred fifty-nine patients with benign biliary strictures, mostly postsurgical, were enrolled for implantation of absorbable biliary stents in the 11 participating Spanish tertiary hospitals. The average patient follow-up was 45.4 ± 15.9 months (range, 12–60 months). The follow-up data included symptoms, biochemical parameters, and ultrasound images at 1, 6, and 12 months and then yearly for up to 60 months. Results The immediate technical and clinical success rates were 100%. In all patients, stent placement resulted in improvement of clinical symptoms and biochemical parameters. The primary mean patency for stent was 86.7, 79.6, and 78.9% at 12, 36, and 60 months, respectively (95% CI). Biliary restenosis and occlusion occurred in 40 (26.6%) patients. Of the 40 patients, 18 (12%) patients were treated with a second stent and 22 (14.6%) patients had operative repair of the recurrent strictures. There were no major complications associated with stent implantation. Conclusions Implantation of an absorbable polydioxanone biliary stent is safe and effective for treatment of benign biliary strictures refractory to balloon dilatation or other biliary intervention. Miguel Angel De Gregorio and Eva Criado contributed equally to this work. * Enrique Alvarez-Arranz kikealvarez86@gmail.com 1 Interventional Radiology Research Group (GITMI), University of Zaragoza, Zaragoza, Spain 2 Interventional Radiology Unit, UDIAT-Centre Diagnòstic, Hospital Universitario Parc Tauli Sabadell, Medicine Department Universidad Autónoma de Barcelona, Barcelona, Spain 3 Interventional Radiology Unit, Hospital Universitario Vall d’Hebron, Barcelona, Spain 4 Interventional Radiology Unit, Hospital Clínic i Provincial, Barcelona, Spain 5 Interventional Radiology Unit, Hospital Universitario La Ribera, Alzira, Valencia, Spain 6 Interventional Radiology Unit, Hospitales Vithas, Madrid, Spain 7 Interventional Radiology Unit, Hospital Universitario Virgen de la Salud, Toledo, Spain 8 Interventional Radiology Unit, Hospital Universitario de Cruces, Bilbao, Spain 9 Interventional Radiology Unit, Hospital Universitario Virgen de la Arrixaca, Murcia, Spain 10 Interventional Radiology Unit, Hospital Universitario La Paz, Madrid, Spain 11 Interventional Radiology Unit, Hospital de Denia Marina Salud, Alicante, Spain European Radiology https://doi.org/10.1007/s00330-020-06797-7