Tips and tricks for the diagnosis and management of biliary stenosis-state of the art review
| Autor: | Andrea Anderloni, Alessandro Repici, Michelangela Mossa, Omero Alessandro Paoluzi, Renato Argirò, Giovanni Monteleone, Giovanna Del Vecchio Blanco, Edoardo Troncone |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Endoscopic ultrasound
Endoscopic ultrasound-guided fine needle aspiration medicine.medical_specialty Magnetic resonance cholangiopancreatography Endoscopic retrograde cholangiopancreatography Percutaneous medicine.diagnostic_test business.industry medicine.medical_treatment Stent Minireviews Malignancy medicine.disease Settore MED/12 Stenosis medicine Cholangioscopy Radiology Differential diagnosis Metal stent business Biliary stenosis Biliary stenosis treatment |
| Zdroj: | World Journal of Gastrointestinal Endoscopy |
| ISSN: | 1948-5190 |
| DOI: | 10.4253/wjge.v13.i10.473 |
| Popis: | Biliary stenosis may represent a diagnostic and therapeutic challenge resulting in a delay in diagnosis and initiation of therapy due to the frequent difficulty in distinguishing a benign from a malignant stricture. In such cases, the diagnostic flowchart includes the sequential execution of imaging techniques, such as magnetic resonance, magnetic resonance cholangiopancreatography, and endoscopic ultrasound, while endoscopic retrograde cholangiopancreatography is performed to collect tissue for histopathological/cytological diagnosis or to treat the stenosis by insertion of stent. The execution of percutaneous transhepatic drainage with subsequent biopsy has been shown to increase the possibility of tissue diagnosis after failure of the above techniques. Although the diagnostic yield of histopathology and imaging has increased with improvements in endoscopic ultrasound and peroral cholangioscopy, differential diagnosis between malignant and benign stenosis may not be easy in some patients, and strictures are classified as indeterminate. In these cases, a multidisciplinary workup including biochemical marker assays and advanced technologies available may speed up a diagnosis of malignancy or avoid unnecessary surgery in the event of a benign stricture. Here, we review recent advancements in the diagnosis and management of biliary strictures and describe tips and tricks to increase diagnostic yields in clinical routine. |
| Databáze: | OpenAIRE |
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