Abstract
We described the treatment for the difficult cases of differential diagnosis in patients with middle to lower biliary strictures. The main reasons of difficult diagnoses are atypical clinical and imaging findings compared to expected histopathological diagnoses. In case of difficult diagnoses, we have to comprehensively diagnose by the case conference among physicians, surgeons, radiologists, and pathologists. In addition, short term follow-up is mandatory to avoid the misdiagnosis.
