The endoscopist and malignant and non-malignant biliary obstruction

Biochim Biophys Acta Mol Basis Dis. 2018 Apr;1864(4 Pt B):1478-1483. doi: 10.1016/j.bbadis.2017.09.013. Epub 2017 Sep 18.

Abstract

Patients with biliary strictures often represent a diagnostic and therapeutic challenge, due to the site and complexity of biliary obstruction and wide differential diagnosis. Multidisciplinary decision making is required to reach an accurate and timely diagnosis and to plan optimal care. Developments in endoscopic ultrasound and peroral cholangioscopy have advanced the diagnostic yield of biliary endoscopy, and novel optical imaging techniques are emerging. Endoscopic approaches to biliary drainage are preferred in most scenarios, and recent advances in therapeutic endoscopic ultrasound allow drainage where the previous alternatives were only percutaneous or surgical. Here we review recent advances in endoscopic practice for the diagnosis and management of biliary strictures. This article is part of a Special Issue entitled: Cholangiocytes in Health and Diseaseedited by Jesus Banales, Marco Marzioni and Peter Jansen.

Keywords: Cholangiocarcinoma; ERCP; Endoscopic ultrasound; Endoscopy; Stents.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Bile Duct Neoplasms / diagnosis*
  • Bile Duct Neoplasms / pathology
  • Bile Ducts / diagnostic imaging*
  • Bile Ducts / pathology
  • Bile Ducts / surgery
  • Biopsy
  • Cholangiocarcinoma / diagnosis*
  • Cholangiocarcinoma / pathology
  • Cholangiocarcinoma / surgery
  • Cholangiopancreatography, Endoscopic Retrograde / methods
  • Cholestasis / diagnosis*
  • Cholestasis / etiology
  • Cholestasis / pathology
  • Cholestasis / surgery
  • Constriction, Pathologic / diagnosis
  • Constriction, Pathologic / etiology
  • Constriction, Pathologic / pathology
  • Constriction, Pathologic / surgery
  • Diagnosis, Differential
  • Drainage / methods
  • Endosonography / methods
  • Humans