PMID- 32466095
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20200928
IS  - 2075-4418 (Print)
IS  - 2075-4418 (Electronic)
IS  - 2075-4418 (Linking)
VI  - 10
IP  - 5
DP  - 2020 May 25
TI  - The Diagnostic Dilemma of Malignant Biliary Strictures.
LID - 10.3390/diagnostics10050337 [doi]
LID - 337
AB  - The differential diagnosis for biliary strictures is broad. However, the 
      likelihood of malignancy is high. Determining the etiology of a biliary stricture 
      requires a comprehensive physical exam, laboratory evaluation, imaging, and 
      ultimately tissue acquisition. Even then, definitive diagnosis is elusive, and 
      many strictures remain indeterminant in origin. This literary review examines the 
      diagnostic dilemma of biliary strictures and presents innovations in both 
      histochemical and endoscopic techniques that have increased the diagnostic power 
      of differentiating benign and malignant strictures. The field of tissue biopsy is 
      revolutionizing with the advent of free DNA mutation profiling, fluorescence in 
      situ hybridization (FISH), and methionyl t-RNA synthetase 1 (MARS 1), which allow 
      for greater testing sensitivity. Endoscopic ultrasound, endoscopic retrograde 
      cholangiopancreatography (ERCP), cholangioscopy, confocal laser endomicroscopy, 
      and intraductal ultrasound build upon existing endoscopic technology to better 
      characterize strictures that would otherwise be indeterminate in etiology. This 
      review uses recent literature to insert innovative technology into the 
      traditional framework of diagnostic methods for malignant biliary strictures.
FAU - Dorrell, Robert
AU  - Dorrell R
AUID- ORCID: 0000-0003-0796-9300
AD  - Department of Medicine, Wake Forest School of Medicine, Winston-Salem, NC 27157, 
      USA.
FAU - Pawa, Swati
AU  - Pawa S
AD  - Division of Gastroenterology, Department of Medicine, Wake Forest School of 
      Medicine, Winston-Salem, NC 27157, USA.
FAU - Zhou, Yi
AU  - Zhou Y
AD  - Department of Pathology, Wake Forest School of Medicine, Winston-Salem, NC 27157, 
      USA.
FAU - Lalwani, Neeraj
AU  - Lalwani N
AUID- ORCID: 0000-0001-5514-2805
AD  - Department of Radiology, Wake Forest School of Medicine, Winston-Salem, NC 27157, 
      USA.
FAU - Pawa, Rishi
AU  - Pawa R
AD  - Division of Gastroenterology, Department of Medicine, Wake Forest School of 
      Medicine, Winston-Salem, NC 27157, USA.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20200525
PL  - Switzerland
TA  - Diagnostics (Basel)
JT  - Diagnostics (Basel, Switzerland)
JID - 101658402
PMC - PMC7277979
OTO - NOTNLM
OT  - cholangioscopy
OT  - confocal laser endomicroscopy
OT  - endoscopic retrograde cholangiopancreatography
OT  - endoscopic ultrasound
OT  - fine-needle aspiration and biopsy
OT  - hepatobiliary malignancy
OT  - intraductal ultrasound
OT  - malignant biliary stricture
OT  - pancreatic cancer
COIS- The authors declare no conflict of interest.
EDAT- 2020/05/30 06:00
MHDA- 2020/05/30 06:01
PMCR- 2020/05/25
CRDT- 2020/05/30 06:00
PHST- 2020/03/31 00:00 [received]
PHST- 2020/05/15 00:00 [revised]
PHST- 2020/05/21 00:00 [accepted]
PHST- 2020/05/30 06:00 [entrez]
PHST- 2020/05/30 06:00 [pubmed]
PHST- 2020/05/30 06:01 [medline]
PHST- 2020/05/25 00:00 [pmc-release]
AID - diagnostics10050337 [pii]
AID - diagnostics-10-00337 [pii]
AID - 10.3390/diagnostics10050337 [doi]
PST - epublish
SO  - Diagnostics (Basel). 2020 May 25;10(5):337. doi: 10.3390/diagnostics10050337.