Current endoscopic approach to indeterminate biliary strictures Review uri icon

Overview

MeSH Major

  • Bile Duct Neoplasms
  • Bile Ducts, Intrahepatic
  • Cholangiocarcinoma
  • Cholangiopancreatography, Endoscopic Retrograde
  • Cholestasis
  • Endosonography

abstract

  • Biliary strictures are considered indeterminate when basic work-up, including transabdominal imaging and endoscopic retrograde cholangiopancreatography with routine cytologic brushing, are non-diagnostic. Indeterminate biliary strictures can easily be mischaracterized which may dramatically affect patient's outcome. Early and accurate diagnosis of malignancy impacts not only a patient's candidacy for surgery, but also potential timely targeted chemotherapies. A significant portion of patients with indeterminate biliary strictures have benign disease and accurate diagnosis is, thus, paramount to avoid unnecessary surgery. Current sampling strategies have suboptimal accuracy for the diagnosis of malignancy. Emerging data on other diagnostic modalities, such as ancillary cytology techniques, single operator cholangioscopy, and endoscopic ultrasonography-guided fine needle aspiration, revealed promising results with much improved sensitivity.

publication date

  • December 2012

Research

keywords

  • Review

Identity

Language

  • eng

PubMed Central ID

  • PMC3501767

Digital Object Identifier (DOI)

  • 10.3748/wjg.v18.i43.6197

PubMed ID

  • 23180939

Additional Document Info

start page

  • 6197

end page

  • 205

volume

  • 18

number

  • 43