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Challenging biliary strictures: pathophysiological features, differential diagnosis, diagnostic algorithms, and new clinically relevant biomarkers - part 1
It is frequently challenging to make the correct diagnosis in patients with biliary strictures. This is particularly important as errors may have disastrous consequences. Benign-appearing strictures treated with stents may later be revealed to be malignant and unnecessary surgery for benign strictur...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
SAGE Publications
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7298429/ https://www.ncbi.nlm.nih.gov/pubmed/32595761 http://dx.doi.org/10.1177/1756284820927292 |
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author | Dumonceau, Jean-Marc Delhaye, Myriam Charette, Nicolas Farina, Annarita |
author_facet | Dumonceau, Jean-Marc Delhaye, Myriam Charette, Nicolas Farina, Annarita |
author_sort | Dumonceau, Jean-Marc |
collection | PubMed |
description | It is frequently challenging to make the correct diagnosis in patients with biliary strictures. This is particularly important as errors may have disastrous consequences. Benign-appearing strictures treated with stents may later be revealed to be malignant and unnecessary surgery for benign strictures carries a high morbidity rate. In the first part of the review, the essential information that clinicians need to know about diseases responsible for biliary strictures is presented, with a focus on the most recent data. Then, the characteristics and pitfalls of the methods used to make the diagnosis are summarized. These include serum biomarkers, imaging studies, and endoscopic modalities. As tissue diagnosis is the only 100% specific tool, it is described in detail, including techniques for tissue acquisition and their yields, how to prepare samples, and what to expect from the pathologist. Tricks to increase diagnostic yields are described. Clues are then presented for the differential diagnosis between primary and secondary sclerosing cholangitis, IgG4-related sclerosing cholangitis, cholangiocarcinoma, pancreatic cancer, autoimmune pancreatitis, and less frequent diseases. Finally, algorithms that will help to achieve the correct diagnosis are proposed. |
format | Online Article Text |
id | pubmed-7298429 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | SAGE Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-72984292020-06-25 Challenging biliary strictures: pathophysiological features, differential diagnosis, diagnostic algorithms, and new clinically relevant biomarkers - part 1 Dumonceau, Jean-Marc Delhaye, Myriam Charette, Nicolas Farina, Annarita Therap Adv Gastroenterol Review It is frequently challenging to make the correct diagnosis in patients with biliary strictures. This is particularly important as errors may have disastrous consequences. Benign-appearing strictures treated with stents may later be revealed to be malignant and unnecessary surgery for benign strictures carries a high morbidity rate. In the first part of the review, the essential information that clinicians need to know about diseases responsible for biliary strictures is presented, with a focus on the most recent data. Then, the characteristics and pitfalls of the methods used to make the diagnosis are summarized. These include serum biomarkers, imaging studies, and endoscopic modalities. As tissue diagnosis is the only 100% specific tool, it is described in detail, including techniques for tissue acquisition and their yields, how to prepare samples, and what to expect from the pathologist. Tricks to increase diagnostic yields are described. Clues are then presented for the differential diagnosis between primary and secondary sclerosing cholangitis, IgG4-related sclerosing cholangitis, cholangiocarcinoma, pancreatic cancer, autoimmune pancreatitis, and less frequent diseases. Finally, algorithms that will help to achieve the correct diagnosis are proposed. SAGE Publications 2020-06-16 /pmc/articles/PMC7298429/ /pubmed/32595761 http://dx.doi.org/10.1177/1756284820927292 Text en © The Author(s), 2020 https://creativecommons.org/licenses/by-nc/4.0/ This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). |
spellingShingle | Review Dumonceau, Jean-Marc Delhaye, Myriam Charette, Nicolas Farina, Annarita Challenging biliary strictures: pathophysiological features, differential diagnosis, diagnostic algorithms, and new clinically relevant biomarkers - part 1 |
title | Challenging biliary strictures: pathophysiological features,
differential diagnosis, diagnostic algorithms, and new clinically relevant
biomarkers - part 1 |
title_full | Challenging biliary strictures: pathophysiological features,
differential diagnosis, diagnostic algorithms, and new clinically relevant
biomarkers - part 1 |
title_fullStr | Challenging biliary strictures: pathophysiological features,
differential diagnosis, diagnostic algorithms, and new clinically relevant
biomarkers - part 1 |
title_full_unstemmed | Challenging biliary strictures: pathophysiological features,
differential diagnosis, diagnostic algorithms, and new clinically relevant
biomarkers - part 1 |
title_short | Challenging biliary strictures: pathophysiological features,
differential diagnosis, diagnostic algorithms, and new clinically relevant
biomarkers - part 1 |
title_sort | challenging biliary strictures: pathophysiological features,
differential diagnosis, diagnostic algorithms, and new clinically relevant
biomarkers - part 1 |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7298429/ https://www.ncbi.nlm.nih.gov/pubmed/32595761 http://dx.doi.org/10.1177/1756284820927292 |
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