2017 Volume 31 Issue 2 Pages 180-186
Bile duct strictures may result from various malignant and benign reasons, and differentiating between a malignant and benign stricture is important in daily practice. Endoscopic retrograde cholangiopancreatography (ERCP) is the most widely used endoscopic procedure in evaluating bile duct strictures. ERCP related procedures include cholangiogram, intra-ductal ultrasonography, tissue samplings, and cholangioscopy. They provide high diagnostic accuracy for differentiate from benign and malignant stricture. In the bile duct cancer, preoperative clinical diagnosis of distant metastases and local extension including invasion of the vessels and longitudinal extension is important. The longitudinal tumor extension varies depending on the gross type and location of tumor. According to frequent intraluminal tumor extension in hilar or upper bile duct cancer; the findings of wall thickness by MDCT and tapering stenosis of the bile duct by detail cholangiography are interpreted with care about the limits of ductal resection of the residual liver lobe as an index. On the other hand, the superficial tumor extension is frequent in the middle or lower bile duct cancer; therefore, peroral cholagioscopy and biopsy are often necessary. ERCP related procedures play a great roll for diagnosis of bile duct cancer.
