Endoscopic diagnosis and management for patients with indeterminate biliary stricture

Abstract

Definitive diagnosis including differentiation between benign and malignancy in patients with indeterminate biliary stricture just using image modalities is often difficult as there are various diseases. EUS and ERCP has been reported as useful. Peroral cholangioscopy makes it possible to observe the biliary stricture and take a biopsy from it under the direct view. Furthermore, probe-based confocal laser endomicroscopy (pCLE) enables in vivo histological assessment in real time, known as "virtual biopsy".

In this review, we have summarized endoscopic diagnosis and management for patients with indeterminate biliary stricture by introducing the characteristics and diagnostic yield in each endoscopic modality.