Endoscopic evaluation of bile duct strictures

Gastrointest Endosc Clin N Am. 2013 Apr;23(2):277-93. doi: 10.1016/j.giec.2012.12.002. Epub 2013 Jan 10.


Differentiating between malignant and benign bile duct strictures is often challenging. Endoscopic retrograde cholangiopancreatography with brush cytology and/or endobiliary forceps biopsy is routinely performed. Advanced cytologic methods such as fluorescence in situ hybridization or digital image analysis increases the sensitivity of cytology. Endoscopic ultrasonography enables detailed examination of tissues surrounding the bile duct stricture and offers the advantage of fine-needle aspiration. Intraductal ultrasonography enables detailed evaluation of bile duct wall layers, and cholangioscopy offers direct visualization of the bile duct lesions. Novel techniques of probe-based confocal laser endomicroscopy and optical coherence tomography have introduced the era of in vivo histology.

Publication types

  • Review

MeSH terms

  • Bile Ducts / diagnostic imaging
  • Bile Ducts / pathology*
  • Biliary Tract Neoplasms / complications
  • Biliary Tract Neoplasms / diagnosis*
  • Cholangiopancreatography, Endoscopic Retrograde*
  • Cholestasis / etiology*
  • Constriction, Pathologic / diagnosis
  • Constriction, Pathologic / etiology
  • Endoscopic Ultrasound-Guided Fine Needle Aspiration
  • Endosonography*
  • Fluoroscopy
  • Humans
  • In Situ Hybridization, Fluorescence
  • Microscopy, Confocal
  • Tomography, Optical Coherence