Diagnostic work-up of bile duct strictures: European Society of Gastrointestinal Endoscopy (ESGE) Guideline

Antonio Facciorusso; Stefano Francesco Crinò; Paraskevas Gkolfakis; Marco Spadaccini; Marianna Arvanitakis; Torsten Beyna; Michiel Bronswijk; Jahnvi Dhar; Mark Ellrichmann; Rodica Gincul; Istvan Hritz; Leena Kylänpää; Belen Martinez-Moreno; Martina Pezzullo; Mihai Rimbaş; Jayanta Samanta; Roy L.J. van Wanrooij; George Webster; Konstantinos Triantafyllou

doi:10.1055/a-2481-7048

Endoscopy, Inhaltsverzeichnis

Endoscopy 2025; 57(02): 166-185
DOI: 10.1055/a-2481-7048

Guideline

Diagnostic work-up of bile duct strictures: European Society of Gastrointestinal Endoscopy (ESGE) Guideline

Antonio Facciorusso

¹Experimental Medicine, Università del Salento, Lecce, Italy (Ringgold ID: RIN18976)

²Clinical Effectiveness Research Group, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway

,

Stefano Francesco Crinò

³Gastroenterology, University of Verona, Verona, Italy

,

Paraskevas Gkolfakis

⁴Gastroenterology, "Konstantopoulio-Patision" General Hospital of Nea Ionia, Athens, Greece

,

Marco Spadaccini

⁵Endoscopy Unit, Istituto Clinico Humanitas, Rozzano, Italy (Ringgold ID: RIN9268)

,

Marianna Arvanitakis

⁶Gastroenterology, Digestive Oncology and Hepatopancreatology, HUB Hôpital Erasme, Brussels, Belgium

,

Torsten Beyna

⁷Internal Medicine, Evangelisches Krankenhaus Düsseldorf, Düsseldorf, Germany

,

Michiel Bronswijk

⁸Gastroenterology and Hepatology, Imelda Hospital, Bonheiden, Belgium (Ringgold ID: RIN81874)

⁹Gastroenterology and Hepatology, KU Leuven University Hospitals Leuven, Leuven, Belgium (Ringgold ID: RIN60182)

,

Jahnvi Dhar

¹⁰Gastroenterology, PGIMER, Chandigarh, India (Ringgold ID: RIN29751)

,

Mark Ellrichmann

¹¹Interdisciplinary Endoscopy, Medical Department I, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany

,

Rodica Gincul

¹²Gastroenterology, Jean Mermoz Private Hospital, Lyon, France (Ringgold ID: RIN89686)

,

Istvan Hritz

¹³Centre for Therapeutic Endoscopy, Semmelweis University, Budapest, Hungary (Ringgold ID: RIN37637)

,

Leena Kylänpää

¹⁴Surgery, Helsinki Univeristy Central Hospital, Helsinki, Finland

,

Belen Martinez-Moreno

¹⁵Endoscopy Unit, Hospital General Universitario de Alicante, Alicante, Spain (Ringgold ID: RIN16802)

,

Martina Pezzullo

¹⁶Radiology, Erasmus Hospital, Bruxelles, Belgium (Ringgold ID: RIN70496)

,

Mihai Rimbaş

¹⁷Gastroenterology, Colentina Clinical Hospital, Bucharest, Romania

¹⁸Internal Medicine Department, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania

,

Jayanta Samanta

¹⁰Gastroenterology, PGIMER, Chandigarh, India (Ringgold ID: RIN29751)

,

Roy L.J. van Wanrooij

¹⁹Gastroenterology and Hepatology, Amsterdam UMC Locatie VUmc, Amsterdam, Netherlands (Ringgold ID: RIN1209)

,

George Webster

²⁰Pancreatobiliary Medicine Unit, University College London, London, United Kingdom of Great Britain and Northern Ireland (Ringgold ID: RIN4919)

,

Konstantinos Triantafyllou

²¹Hepatogastroenterology Unit, 2nd Department of Internal Medicine, Propaedeutic, Medical School, National and Kapodistrian University of Athens, "Attikon" University General Hospital, Athens, Greece

› Institutsangaben

Abstract

Main recommendations

1 ESGE recommends the combination of endoscopic ultrasound-guided tissue acquisition (EUS-TA) and endoscopic retrograde cholangiopancreatography (ERCP)-based tissue acquisition as the preferred diagnostic approach for tissue acquisition in patients with jaundice and distal extrahepatic biliary stricture in the absence of a pancreatic mass.

2 ESGE suggests that brushing cytology should be completed along with fluoroscopy-guided biopsies, wherever technically feasible, in patients with perihilar biliary strictures.

3 ESGE suggests EUS-TA for perihilar strictures when ERCP-based modalities yield insufficient results, provided that curative resection is not feasible and/or when cross-sectional imaging has shown accessible extraluminal disease.

4 ESGE suggests using standard ERCP diagnostic modalities at index ERCP. In the case of indeterminate biliary strictures, ESGE suggests cholangioscopy-guided biopsies, in addition to standard ERCP diagnostic modalities. Additional intraductal biliary imaging modalities can be selectively used, based on clinical context, local expertise, and resource availability.

Volltext

Referenzen

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