Abstract
Hilar biliary strictures (HBS) are difficult to diagnose and treat, because their etiology is not always ascertained by all the available diagnostic tests. If a diagnosis cannot be made, HBS are classified as indeterminate. In recent years, both new imaging and endoscopic techniques, and a better understanding of hepato-biliary diseases have significantly reduced the number of patients diagnosed with indeterminate HBS. A complete work-up of these patients is mandatory to exclude malignancy and is based on laboratory tests, radiological imaging, and endoscopic procedures. Briefly, a decision-making process for the diagnosis of patients with HBS is discussed and a diagnostic algorithm is proposed.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
NCCN Guidelines. Version I. 2018. NCCN org.February 14, 2018.
Singh A, Gelrud A, Agarwal B. Biliary strictures: diagnostic considerations and approach. Gastroenterol Rep. 2015;3:22–31.
Thomasset SC, Saunders D, Holland A, et al. Malignant biliary strictures in patients with a normal bilirubin and/or normal liver enzymes. HPB. 2015;17:969–74.
Razumilava N, Gores GJ. Classification, diagnosis, and management of cholangiocarcinoma. Clin Gastroenetrol Hepatol. 2013;11:13–21.
Dioscoridi L, Staiano T, Carrara S, et al. Gestione multidisciplinare del colangiocarcinoma. Oncology Update. Giornale Italiano di Endoscopia Digestiva. 2016;4:19–32.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2020 Springer Nature Switzerland AG
About this chapter
Cite this chapter
de Bellis, M., Di Girolamo, E. (2020). Hilar Strictures: Algorithm. In: Mutignani, M., Albert, J.G., Fabbri, C. (eds) Endotherapy in Biliopancreatic Diseases: ERCP Meets EUS. Springer, Cham. https://doi.org/10.1007/978-3-030-42569-2_56
Download citation
DOI: https://doi.org/10.1007/978-3-030-42569-2_56
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-42568-5
Online ISBN: 978-3-030-42569-2
eBook Packages: MedicineMedicine (R0)