Current endoscopic approach to indeterminate biliary strictures  

作　　者：David W Victor Stuart Sherman Tarkan Karakan Mouen A Khashab 

机构地区：[1]Department of Medicine, Johns Hopkins Hospital, Baltimore, MD 21287, United States [2]Department of Medicine, Indiana University School of Medicine, Indianapolis, IN 46202, United States [3]Department of Medicine, Gazi University, 06710 Ankara, Turkey

出　　处：《World Journal of Gastroenterology》2012年第43期6197-6205,共9页世界胃肠病学杂志（英文版）

摘　　要：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.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.

关 键 词：Indeterminate stricture Bile duct Single operator cholangioscope CHOLANGIOSCOPY Endoscopic ultrasound Endoscopic retrograde cholangiopancrea-tography Bile duct stricture Indeterminate biliary stricture Confocal microscopy Transpapillary biopsy CHOLANGIOCARCINOMA Primary sclerosing cholangitis Spyglass 

分 类 号：R735.8[医药卫生—肿瘤]