ArticleHPB : the official journal of the International Hepato Pancreato Biliary Association2022
Consensus guidelines on the role of cholangioscopy to diagnose indeterminate biliary stricture.
Article in HPB : the official journal of the International Hepato Pancreato Biliary Association, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 4 of them syntheses that pooled it.
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Who cites it
32 citing papers in PubMed, 4 syntheses or guidelines pooled it, 56 citations in OpenAlex.
- Clinical Practice Guidelines for Peroral Cholangioscopy.Journal of hepato-biliary-pancreatic sciences · 2026Guideline
- FIRST BRAZILIAN CONSENSUS ON CHOLANGIOPANCREATOSCOPY BY THE BRAZILIAN SOCIETY OF DIGESTIVE ENDOSCOPY (SOBED).Arquivos de gastroenterologia · 2026Guideline
- Chinese national clinical practice guideline on diagnosis and treatment of biliary tract cancers.Chinese medical journal · 2024Guideline
- Clinical practice guideline on the use of single-operator cholangioscopy in the diagnosis of indeterminate biliary stricture and the treatment of difficult biliary stones.Surgical endoscopy · 2024Guideline
- Diagnostic value of peroral choledochoscopy combined with modified biopsy forceps for malignant biliary strictures: a two-center retrospective study.Surgical endoscopy · 2026Article
- Clinical Validation of AI-Assisted Evaluation of Indeterminate Biliary Strictures in Digital-Single Operator Cholangioscopy: A Transcontinental Multicentric Study.Clinical and translational gastroenterology · 2026Article
- Percutaneous Transhepatic Endobiliary Microwave Ablation Before Stenting for Malignant Obstructive Jaundice: Evidence Synthesis and Preliminary Technical Experience.Medicina (Kaunas, Lithuania) · 2026Review
- Multimodal endoscopic diagnosis in biliary oncology: integrating EUS-guided tissue acquisition and cholangioscopy for personalized cancer care.Frontiers in gastroenterology (Lausanne, Switzerland) · 2026Article
- Initial Results from a Novel Video Cholangiopancreatoscope: An International Multicenter Study.Endoscopy international open · 2026Article
- Cholangioscopy-guided ERCP: expanding diagnostic and therapeutic applications.Frontiers in medicine · 2026Review
- Clonorchis sinensis and cholangiocarcinoma: molecular mechanisms and biomarker advances.Parasite (Paris, France) · 2026Review
- Two scopes, one mission: An integrated approach of endoscopic retrograde cholangiopancreatography and endoscopic ultrasound to biliary strictures.World journal of gastroenterology · 2025Review
- European Consensus Recommendations for Direct Cholangioscopy and Pancreatoscopy Using a Modified Delphi Process.United European gastroenterology journal · 2025Article
- The value of cholangioscopy-guided bite-on-bite (-on bite) biopsies in indeterminate biliary duct strictures.Endoscopy · 2025Article
- Artificial intelligence for automatic diagnosis and pleomorphic morphological characterization of malignant biliary strictures using digital cholangioscopy.Scientific reports · 2025Article
- Contribution of the EyeMAX™ 11Fr (Micro-Tech) digital single-operator cholangioscope with a wide working channel: a multicenter pilot study on the first French experiences.Therapeutic advances in gastroenterology · 2025Article
- Ablatio-bilica: safety of biliary intraductal radiofrequency ablation in patients with unresectable extrahepatic biliary tract cancer undergoing systemic anti-tumor therapy: a phase II, multi-center, randomized, and controlled study.Frontiers in oncology · 2025Article
- Feasibility of Peroral Cholangioscopy in the Initial Endoscopic Retrograde Cholangiopancreatography for Malignant Biliary Strictures.Diagnostics (Basel, Switzerland) · 2024Article
- Imaging of Benign Biliary Tract Disease.The Indian journal of radiology & imaging · 2024Review
- The updated Asia-Pacific consensus statement on the role of endoscopic management in malignant hilar biliary obstruction.Endoscopy international open · 2024Article
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Authors and funding
23 authors at 16 institutions in 11 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIndeterminate strictures pose a therapeutic dilemma. In recent years, cholangioscopy has evolved and the availability of cholangioscopy has increased. However, the position of cholangioscopy in the diagnostic algorithm to diagnose malignancy have not been well established. We aim to develop a consensus statement regarding the clinical role of cholangioscopy in the diagnosis of indeterminate biliary strictures.
methodsThe international experts reviewed the evidence and modified the statements using a three-step modified Delphi method. Each statement achieves consensus when it has at least 80% agreement.
resultsNine final statements were formulated. An indeterminate biliary stricture is defined as that of uncertain etiology under imaging or tissue diagnosis. When available, cholangioscopic assessment and guided biopsy during the first round of ERCP may reduce the need to perform multiple procedures. Cholangioscopy are helpful in diagnosing malignant biliary strictures by both direct visualization and targeted biopsy. The absence of disease progression for at least 6 months is supportive of non-malignant etiology. Direct per-oral cholangioscopy provides the largest accessory channel, better image definition, with image enhancement but is technically demanding. Image enhancement during cholangioscopy may increase the diagnostic sensitivity of visual impression of malignant biliary strictures. Cholangioscopic imaging characteristics including tumor vessels, papillary projection, nodular or polypoid mass, and infiltrative lesions are highly suggestive for neoplastic/malignant biliary disease. The risk of cholangioscopy related cholangitis is higher than in standard ERCP, necessitating prophylactic antibiotics and ensuring adequate biliary drainage. Per-oral cholangioscopy may not be the modality of choice in the evaluation of distal biliary strictures due to inherent technical difficulties.
conclusionEvidence supports that cholangioscopy has an adjunct role to abdominal imaging and ERCP tissue acquisition in order to evaluate and diagnose indeterminate biliary strictures.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.