ENDOSCOPIC DIAGNOSIS OF INDETERMINATE BILIARY STRICTURES

Abstract

Biliary stricture is a common condition and it is necessary to differentiate between benign and malignant biliary strictures. Previous studies reported that approximately 3 to 17％ of patients undergoing surgery for suspected malignancy are found to have benign biliary stricture on postoperative pathological examination of resected specimens. Although most cases of benign stricture are primary sclerosing cholangitis (PSC), IgG4-related sclerosing cholangitis (IgG4-SC) and postoperative stricture, a few cases have secondary sclerosing cholangitis due to several reasons or non-specific cholangitis of unknown etiology. For accurate diagnosis and treatment, it is important to distinguish benign from malignant strictures and determine whether IgG4-SC is present or not. However, there are some difficult cases that have required surgery despite advanced imaging modalities and preoperative tissue samplings.