Current endoscopic approach to indeterminate biliary strictures

Victor D. W., Sherman S., KARAKAN T., Khashab M. A.

WORLD JOURNAL OF GASTROENTEROLOGY, cilt.18, sa.43, ss.6197-6205, 2012 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 18 Sayı: 43
  • Basım Tarihi: 2012
  • Doi Numarası: 10.3748/wjg.v18.i43.6197
  • Dergi Adı: WORLD JOURNAL OF GASTROENTEROLOGY
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Sayfa Sayıları: ss.6197-6205
  • Anahtar Kelimeler: Indeterminate stricture, Bile duct, Single operator cholangioscope, Cholangioscopy, Endoscopic ultrasound, Endoscopic retrograde cholangiopancreatography, Bile duct stricture, Indeterminate biliary stricture, Confocal microscopy, Transpapillary biopsy, Cholangiocarcinoma, Primary sclerosing cholangitis, Spyglass, FINE-NEEDLE-ASPIRATION, BILE-DUCT STRICTURES, MAGNETIC-RESONANCE CHOLANGIOPANCREATOGRAPHY, SINGLE-OPERATOR CHOLANGIOSCOPY, PRIMARY SCLEROSING CHOLANGITIS, DIRECT PERORAL CHOLANGIOSCOPY, IN-SITU HYBRIDIZATION, BRUSH CYTOLOGY, PANCREATICOBILIARY STRICTURES, INTRADUCTAL ULTRASONOGRAPHY
  • Gazi Üniversitesi Adresli: Evet

Özet

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. (C) 2012 Baishideng. All rights reserved.