Abstract
Indeterminate biliary strictures (IDBSs) account for 20% of all biliary strictures. They are defined as biliary strictures of unknown etiology after evaluation by endoscopic retrograde cholangiopancreatography (ERCP) with brush cytology or intraductal biopsies. Identification of the etiology of a biliary stricture is prudent for timely evaluation and management. Appropriate evaluation of biliary strictures requires a detailed history and physical exam, laboratory assessment, imaging, and endoscopic evaluation. ERCP is the primary endoscopic modality for characterization of biliary strictures, with several proposed techniques to improve diagnostic yield. Other endoscopic modalities, such as peroral cholangioscopy (POC), endoscopic ultrasound (EUS), intraductal ultrasound (IDUS), and confocal laser microendoscopy (CLE), have demonstrated their individual strengths in improving diagnostic accuracy and should be considered in the evaluation of IDBSs. Future directions in the evaluation of IDBS are currently being studied for their diagnostic accuracy, and these include volumetric laser endomicroscopy (VLE); fluorescence in situ hybridization (FISH); percutaneous transhepatic cholangiography; and mutation profiling samples of free DNA, microRNA, and transfer RNA.
Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
