Current endoscopic approach to indeterminate biliary strictures

David W. Victor, Stuart Sherman, Tarkan Karakan, Mouen A. Khashab

Research output: Contribution to journalArticle

31 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)6197-6205
Number of pages9
JournalWorld Journal of Gastroenterology
Volume18
Issue number43
DOIs
StatePublished - 2012

Fingerprint

Pathologic Constriction
Unnecessary Procedures
Endosonography
Endoscopic Retrograde Cholangiopancreatography
Fine Needle Biopsy
Cell Biology
Early Diagnosis
Neoplasms
Drug Therapy

Keywords

  • Bile duct
  • Bile duct stricture
  • Cholangiocarcinoma
  • Cholangioscopy
  • Confocal microscopy
  • Endoscopic retrograde cholangiopancreatography
  • Endoscopic ultrasound
  • Indeterminate biliary stricture
  • Indeterminate stricture
  • Primary sclerosing cholangitis
  • Single operator cholangioscope
  • Spyglass
  • Transpapillary biopsy

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Current endoscopic approach to indeterminate biliary strictures. / Victor, David W.; Sherman, Stuart; Karakan, Tarkan; Khashab, Mouen A.

In: World Journal of Gastroenterology, Vol. 18, No. 43, 2012, p. 6197-6205.

Research output: Contribution to journalArticle

Victor, David W. ; Sherman, Stuart ; Karakan, Tarkan ; Khashab, Mouen A. / Current endoscopic approach to indeterminate biliary strictures. In: World Journal of Gastroenterology. 2012 ; Vol. 18, No. 43. pp. 6197-6205.
@article{e45118e7966147fd890cb92e62343254,
title = "Current endoscopic approach to indeterminate biliary strictures",
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.",
keywords = "Bile duct, Bile duct stricture, Cholangiocarcinoma, Cholangioscopy, Confocal microscopy, Endoscopic retrograde cholangiopancreatography, Endoscopic ultrasound, Indeterminate biliary stricture, Indeterminate stricture, Primary sclerosing cholangitis, Single operator cholangioscope, Spyglass, Transpapillary biopsy",
author = "Victor, {David W.} and Stuart Sherman and Tarkan Karakan and Khashab, {Mouen A.}",
year = "2012",
doi = "10.3748/wjg.v18.i43.6197",
language = "English",
volume = "18",
pages = "6197--6205",
journal = "World Journal of Gastroenterology",
issn = "1007-9327",
publisher = "WJG Press",
number = "43",

}

TY - JOUR

T1 - Current endoscopic approach to indeterminate biliary strictures

AU - Victor, David W.

AU - Sherman, Stuart

AU - Karakan, Tarkan

AU - Khashab, Mouen A.

PY - 2012

Y1 - 2012

N2 - 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.

AB - 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.

KW - Bile duct

KW - Bile duct stricture

KW - Cholangiocarcinoma

KW - Cholangioscopy

KW - Confocal microscopy

KW - Endoscopic retrograde cholangiopancreatography

KW - Endoscopic ultrasound

KW - Indeterminate biliary stricture

KW - Indeterminate stricture

KW - Primary sclerosing cholangitis

KW - Single operator cholangioscope

KW - Spyglass

KW - Transpapillary biopsy

UR - http://www.scopus.com/inward/record.url?scp=84873904926&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84873904926&partnerID=8YFLogxK

U2 - 10.3748/wjg.v18.i43.6197

DO - 10.3748/wjg.v18.i43.6197

M3 - Article

C2 - 23180939

AN - SCOPUS:84873904926

VL - 18

SP - 6197

EP - 6205

JO - World Journal of Gastroenterology

JF - World Journal of Gastroenterology

SN - 1007-9327

IS - 43

ER -