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©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Sep 28, 2023; 29(36): 5198-5210
Published online Sep 28, 2023. doi: 10.3748/wjg.v29.i36.5198
Published online Sep 28, 2023. doi: 10.3748/wjg.v29.i36.5198
Clinical approach to indeterminate biliary strictures: Clinical presentation, diagnosis, and workup
Sujani Yadlapati, Department of Gastroenterology and Hepatology, Indiana University Hospital, Indianapolis, IN 46202, USA
Ramzi Mulki, Sergio A Sánchez-Luna, Ali M Ahmed, Kondal Rao Kyanam Kabir Baig, Shajan Peter, Department of Gastroenterology and Hepatology, University of Alabama at Birmingham, Birmingham, AL 35294, USA
Author contributions: Yadlapati S and Mulki R contributed to the literature review and drafting the manuscript; Sánchez-Luna SA and Ahmed AM provided valuable assistance in manuscript preparation; Kyanam Kabir Baig KR and Peter S played a role in conceptualization and final review; Yadlapati S lead author responsible for conducting the, organizing the paper’s structure.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Sujani Yadlapati, MD, Doctor, Department of Gastroenterology and Hepatology, Indiana University Hospital, 500 N University Blvd, Indianapolis, IN 46202, United States. syadlapati@iuhealth.org
Received: April 25, 2023
Peer-review started: April 25, 2023
First decision: July 9, 2023
Revised: July 23, 2023
Accepted: August 21, 2023
Article in press: August 21, 2023
Published online: September 28, 2023
Peer-review started: April 25, 2023
First decision: July 9, 2023
Revised: July 23, 2023
Accepted: August 21, 2023
Article in press: August 21, 2023
Published online: September 28, 2023
Core Tip
Core Tip: Despite advances in imaging and endoscopy, bile duct strictures remain challenging. Timely detection of malignant strictures is crucial. Conventional techniques play a crucial role in diagnosis, but indeterminate biliary strictures (IDBSs) require multiple diagnostic tools. This review discusses etiology, diagnosis, and workup of IDBSs, presenting an evidence-based algorithm focusing on traditional tissue sampling techniques and innovative technologies. The importance of future research is emphasized.