Practical Management of Indeterminate Biliary Strictures.

Affiliation

Division of Gastroenterology and Hepatology, Thomas Jefferson University, 132 South 10th Street, 585 Main Building, Philadelphia, PA 19107, USA. Electronic address: [Email]

Abstract

Indeterminate biliary strictures pose a diagnostic and therapeutic challenge. Although underlying malignancy is a primary concern, biliary strictures may result from benign processes. An accurate diagnosis is paramount to define the treatment strategy and minimize morbidity. The limitations of traditional endoscopic retrograde cholangiopancreatography-based tissue acquisition with cytology brushings are well-documented. Endoscopic retrograde cholangiopancreatography is generally unable to determine a stricture's etiology. Complementary advanced endoscopic imaging and multimodal tissue acquisition have evolved. Careful consideration of the clinical presentation, location of the stricture, and interpretation of imaging constitute the most optimal approach for diagnosis and management.

Keywords

Cholangiocarcinoma,Cytology,ERCP,EUS,FISH,Indeterminate biliary stricture,PSC,