Determining the Indeterminate Biliary Stricture: Cholangioscopy and Beyond
Publication Date
2020
Journal Title
Curr Gastroenterol Rep
Abstract
© 2020, Springer Science+Business Media, LLC, part of Springer Nature. Purpose of Review: Indeterminate biliary strictures (IDBS) continue to be an area of frustration for clinicians. Standard endoscopic retrograde cholangiopancreatography (ERCP) with conventional brush cytology and/or forceps biopsy has a low sensitivity for distinguishing benign from malignant biliary strictures. A delay in diagnosis of malignancy has consequences for subsequent therapy or surgery. In this article, we review current and emerging technologies that may aid in this diagnostic dilemma. Recent Findings: Several technologies have been utilized in IDBS to establish a diagnosis which include peroral cholangioscopy, confocal laser endomicroscopy, endoscopic ultrasound with fine needle aspiration, intraductal ultrasound, optical coherence tomography, fluorescence in situ hybridization, next generation sequencing, integrated molecular pathology, and DNA-image cytometry. Summary: While cholangioscopy and confocal laser endomicroscopy have become standards of care in expert centers for the evaluation of patients with IDBS, there are several endoscopic and molecular modalities that may also aid in establishing a diagnosis. Further head-to-head prospective diagnostic studies as well as cost-efficacy studies are needed.
Volume Number
22
Issue Number
12
Pages
58
Document Type
Article
Status
Faculty
Facility
School of Medicine
Primary Department
Gastroenterology
PMID
DOI
10.1007/s11894-020-00797-9