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Other Benign Biliary Strictures: Sclerosing Cholangitis, Autoimmune Cholangitis, Post-Liver Transplant

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ERCP and EUS

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Abstract

Within the broad spectrum of biliary pathology, one of the most challenging diagnostic dilemmas is the evaluation of biliary strictures, particularly when imaging and cytopathology results are nondiagnostic. The differential diagnosis for an indeterminate biliary stricture encompasses both benign and malignant processes. Diagnosis is often delayed due to the indolent disease course of benign etiologies and the slow growth of cholangiocarcinomas, which can have a profound impact on patient morbidity and mortality. While exclusion of malignancy is of principal concern, establishing a definitive diagnosis for benign biliary strictures is also important for appropriate management, but potentially challenging, especially in the setting of hilar and peripheral liver disease. In addition, stricturing diseases can mimic one another on imaging, further contributing to variable interobserver agreement in the interpretation of radiographic findings. ERCP can play an important role in the diagnosis and management of these benign biliary diseases.

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Authors and Affiliations

  1. Division of Gastroenterology, Hepatology, and Nutrition, University of Pittsburgh Medical Center, 200 Lothrop St., PUH, C-Wing, Mezzanine Level, Pittsburgh, PA 15213, USA

    Charles C. Gabbert MD

  2. Department of Medicine, University of Pittsburgh Medical Center Presbyterian, 200 Lothrop St., PUH, C-Wing, Mezzanine Level, Pittsburgh, PA 15213, USA

    Assoc. Prof. Jennifer Chennat MD

  3. Department of Medicine, Department of Medicine, Division of Gastroenterology, Hepatology, and Nutrition, University of Pittsburgh Medical Center Presbyterian, 200 Lothrop St., PUH, C-Wing, Mezzanine Level, Pittsburgh, PA 15213, USA

    Adam Slivka MD, PhD

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  1. Charles C. Gabbert MD
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  2. Assoc. Prof. Jennifer Chennat MD
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  3. Adam Slivka MD, PhD
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Correspondence to Adam Slivka MD, PhD .

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  1. Gastroenterology, Hepatology, and Endoscopy, Brigham and Women’s Hospital, Boston, Massachusetts, USA

    Linda S. Lee

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Gabbert, C., Chennat, J., Slivka, A. (2015). Other Benign Biliary Strictures: Sclerosing Cholangitis, Autoimmune Cholangitis, Post-Liver Transplant. In: Lee, L. (eds) ERCP and EUS. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-2320-5_9

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