Post-cholecystectomy benign biliary strictures (PCBS) represent a significant clinical challenge, occurring in 0.3–0.7% of laparoscopic cholecystectomies. Despite their clinical impact, the optimal endoscopic management strategy remains ill-defined, particularly regarding the choice between multiple plastic stents (MPS) and fully covered self-expanding metal stents (FCSEMS). This scoping review therefore aimed to synthesize the current evidence on PCBS management and identify areas requiring further research.

We conducted a systematic search of PubMed, Embase, Scopus, and ClinicalTrials.gov for all publications through 14 October 2025, following Joanna Briggs Institute (JBI) and PRISMA-ScR guidance. The search strategy combined database-specific subject headings (e.g., MeSH, Emtree) and free-text keywords related to PCBS and their endoscopic management with MPS and FCSEMS. Two authors independently screened all titles, abstracts, and full-text articles for eligibility, with discrepancies resolved by consensus.

Following deduplication, 3,231 records were screened, with 3,063 excluded at the title and abstract stage. The remaining 168 articles underwent full-text review, of which 64 met the inclusion criteria and were incorporated into the synthesis. Conference abstracts meeting criteria were also included but are presented separately.

Among studies reporting outcomes for PCBS patients treated with MPS, most cohorts comprised predominantly homogeneous PCBS populations, with restenosis rates ranging from 0% to 33.3% (median 10.2%, IQR 5.3%–18.5%). In contrast, substantially fewer studies reported sufficient numbers of PCBS patients treated with FCSEMS, with reported restenosis rates ranging from 10.7% to 15.4% (median 13.1%).

Only one randomized comparative trial (Coté et al., JAMA 2016) directly compared FCSEMS with MPS; however, outcomes were not stratified by stricture etiology, precluding extraction of PCBS-specific data. Several additional studies evaluated heterogeneous postoperative benign biliary stricture cohorts without separately reporting outcomes for the PCBS subgroup.

Available evidence suggests that MPS therapy provides favorable long-term outcomes for PCBS. Although FCSEMS may demonstrate comparable long-term results, the evidence is less well established owing to the scarcity of PCBS-specific data. Heterogeneous definitions of restenosis, inconsistent follow-up, and the absence of rigorous comparative trials further limit evidence-based stent selection. These gaps highlight the need for prospective, etiology-specific studies using standardized outcome definitions to guide optimal endoscopic management of PCBS.