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Endoscopic diagnosis of biliary tract disease.

Kalaitzakis, Evangelos LU and Webster, George J (2012) In Current Opinion in Gastroenterology 28(3). p.273-279
Abstract
PURPOSE OF REVIEW: Endoscopic diagnosis of biliary disease is challenging due to difficulties in access, visualization, and sampling. Recent advances in endoscopic technology, ancillary diagnostic methods, and our understanding of autoimmune pancreatitis (AIP) and IgG4-related cholangitis (IRC) have led to improvements in the endoscopic diagnosis of pancreaticobiliary disease.



RECENT FINDINGS: Single-operator cholangioscopy overcomes several of the limitations of mother-baby cholangioscopy enhancing the diagnostic accuracy in indeterminate pancreaticobiliary disease. Probe-based confocal laser endomicroscopy has been recently shown to provide a significantly higher accuracy for the diagnosis of malignant biliary... (More)
PURPOSE OF REVIEW: Endoscopic diagnosis of biliary disease is challenging due to difficulties in access, visualization, and sampling. Recent advances in endoscopic technology, ancillary diagnostic methods, and our understanding of autoimmune pancreatitis (AIP) and IgG4-related cholangitis (IRC) have led to improvements in the endoscopic diagnosis of pancreaticobiliary disease.



RECENT FINDINGS: Single-operator cholangioscopy overcomes several of the limitations of mother-baby cholangioscopy enhancing the diagnostic accuracy in indeterminate pancreaticobiliary disease. Probe-based confocal laser endomicroscopy has been recently shown to provide a significantly higher accuracy for the diagnosis of malignant biliary strictures than achieved by endoscopic retrograde cholangiopancreatogram and standard tissue acquisition, and has the potential to develop into a useful adjunct method of cholangioscopy. Fluorescence in-situ hybridization increases the sensitivity of routine brush cytology without compromising specificity in patients with indeterminate biliary strictures. The diagnosis of AIP/IRC remains challenging. The recently published international consensus criteria for AIP have included data on the potential diagnostic utility of endoscopic retrograde pancreatogram and endoscopic ampullary biopsies.



SUMMARY: Recent technical advances as well as ancillary diagnostic methods have improved the diagnostic accuracy of conventional endoscopic techniques. Future refinement of endoscopic methods may further improve diagnostic approaches to biliary disease. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Current Opinion in Gastroenterology
volume
28
issue
3
pages
273 - 279
publisher
Lippincott Williams & Wilkins
external identifiers
  • wos:000302945700015
  • pmid:22343346
  • scopus:84859882535
ISSN
0267-1379
DOI
10.1097/MOG.0b013e328351436e
language
English
LU publication?
yes
id
33220edf-37c3-4d1d-bf8e-93f441c61727 (old id 2366767)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/22343346?dopt=Abstract
date added to LUP
2012-03-02 12:27:56
date last changed
2017-01-01 07:46:41
@article{33220edf-37c3-4d1d-bf8e-93f441c61727,
  abstract     = {PURPOSE OF REVIEW: Endoscopic diagnosis of biliary disease is challenging due to difficulties in access, visualization, and sampling. Recent advances in endoscopic technology, ancillary diagnostic methods, and our understanding of autoimmune pancreatitis (AIP) and IgG4-related cholangitis (IRC) have led to improvements in the endoscopic diagnosis of pancreaticobiliary disease. <br/><br>
<br/><br>
RECENT FINDINGS: Single-operator cholangioscopy overcomes several of the limitations of mother-baby cholangioscopy enhancing the diagnostic accuracy in indeterminate pancreaticobiliary disease. Probe-based confocal laser endomicroscopy has been recently shown to provide a significantly higher accuracy for the diagnosis of malignant biliary strictures than achieved by endoscopic retrograde cholangiopancreatogram and standard tissue acquisition, and has the potential to develop into a useful adjunct method of cholangioscopy. Fluorescence in-situ hybridization increases the sensitivity of routine brush cytology without compromising specificity in patients with indeterminate biliary strictures. The diagnosis of AIP/IRC remains challenging. The recently published international consensus criteria for AIP have included data on the potential diagnostic utility of endoscopic retrograde pancreatogram and endoscopic ampullary biopsies. <br/><br>
<br/><br>
SUMMARY: Recent technical advances as well as ancillary diagnostic methods have improved the diagnostic accuracy of conventional endoscopic techniques. Future refinement of endoscopic methods may further improve diagnostic approaches to biliary disease.},
  author       = {Kalaitzakis, Evangelos and Webster, George J},
  issn         = {0267-1379},
  language     = {eng},
  number       = {3},
  pages        = {273--279},
  publisher    = {Lippincott Williams & Wilkins},
  series       = {Current Opinion in Gastroenterology},
  title        = {Endoscopic diagnosis of biliary tract disease.},
  url          = {http://dx.doi.org/10.1097/MOG.0b013e328351436e},
  volume       = {28},
  year         = {2012},
}