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Review
. 2024 Dec 25;14(1):29.
doi: 10.3390/jcm14010029.

An Approach to and Treatment of Indeterminate Biliary Strictures: A Comprehensive Review of the Literature

Giovanna Impellizzeri  1 , Maria Vittoria Grassini  2 , Giulio Donato  1 , Claudio Giovanni De Angelis  1 , Nico Pagano  1
Affiliations
Review

An Approach to and Treatment of Indeterminate Biliary Strictures: A Comprehensive Review of the Literature

Giovanna Impellizzeri et al. J Clin Med. .

Abstract

This review aims to focus on what we know about the management of biliary strictures of unknown etiology, especially exploring our diagnostic armamentarium in the setting of indeterminate biliary strictures. Presently, this is a current issue that has a relevant impact both on patient prognosis, often delaying diagnosis, and on overall costs associated with repeating diagnostic procedures, sometimes performed with very expensive devices. We also focus on current biliary drainage approaches, providing an overview of therapeutic options, endoscopic or not.

Keywords: ERCP; EUS; cholangiocarcinoma; cholangioscopy; strictures.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Double biliary stricture in pancreatic cancer with liver perihilar metastasis.
Figure 2
Figure 2
Hilar cholangiocarcinoma stricture.
Figure 3
Figure 3
FNB of a suspicious extrahepatic cholangiocarcinoma (white arrow) with cystic duct involvement (arrowhead).
Figure 4
Figure 4
Spyglass device with spybite forceps during cholangioscopy.
Figure 5
Figure 5
Regular hepatic confluence appearance during cholangioscopy.
Figure 6
Figure 6
Hilar cholangiocarcinoma stricture appearance during cholangioscopy.
Scheme 1
Scheme 1
Schematic diagnostic approaches available to manage indeterminate biliary strictures.
See this image and copyright information in PMC

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