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Hilar Strictures: Algorithm

  • Mario de BellisEmail author
  • Elena Di Girolamo
Chapter
  • 149 Downloads

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.

Keywords

Hilar biliary strictures Indeterminate biliary strictures Biliary malignancy Cholangiocarcinoma Diagnosis 

References

  1. 1.
    NCCN Guidelines. Version I. 2018. NCCN org.February 14, 2018.Google Scholar
  2. 2.
    Singh A, Gelrud A, Agarwal B. Biliary strictures: diagnostic considerations and approach. Gastroenterol Rep. 2015;3:22–31.CrossRefGoogle Scholar
  3. 3.
    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.CrossRefGoogle Scholar
  4. 4.
    Razumilava N, Gores GJ. Classification, diagnosis, and management of cholangiocarcinoma. Clin Gastroenetrol Hepatol. 2013;11:13–21.CrossRefGoogle Scholar
  5. 5.
    Dioscoridi L, Staiano T, Carrara S, et al. Gestione multidisciplinare del colangiocarcinoma. Oncology Update. Giornale Italiano di Endoscopia Digestiva. 2016;4:19–32.Google Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Division of Gastroenterology and Digestive Endoscopy, Department of Abdominal OncologyIstituto Nazionale Tumori – IRCCS – Fondazione G. PascaleNapoliItaly

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