Browsing by Subject "Biliary strictures"

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    Clinical approach to indeterminate biliary strictures: Clinical presentation, diagnosis, and workup
    (Baishideng, 2023) Yadlapati, Sujani; Mulki, Ramzi; Sánchez-Luna, Sergio A.; Ahmed, Ali M.; Kyanam Kabir Baig, Kondal Rao; Peter, Shajan; Medicine, School of Medicine
    Despite advances in cross-sectional imaging and endoscopic technology, bile duct strictures remain a challenging clinical entity. It is crucial to make an early determination of benign or malignant nature of biliary strictures. Early diagnosis not only helps with further management but also minimizes mortality and morbidity associated with delayed diagnosis. Conventional imaging and endoscopic techniques, particularly endoscopic retrograde cholangiopancreatography (ERCP) and tissue sampling techniques play a key in establishing a diagnosis. Indeterminate biliary strictures (IDBSs) have no definite mass on imaging or absolute histopathological diagnosis and often warrant utilization of multiple diagnostics to ascertain an etiology. In this review, we discuss possible etiologies, clinical presentation, diagnosis, and management of IDBSs. Based on available data and expert opinion, we depict an evidence based diagnostic algorithm for management of IDBSs. Areas of focus include use of traditional tissue sampling techniques such as ERCP with brush cytology, intraductal biopsies, fluorescence in situ hybridization and flow cytometry. We also describe the role of endoscopic ultrasound (EUS)-guided fine needle aspiration and biopsies, cholangioscopy, confocal laser endomicroscopy, and intraductal EUS in management of IDBSs.
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    Impact of Artificial Intelligence on Pancreaticobiliary Endoscopy
    (MDPI, 2025-01-24) Jain, Aryan; Pabba, Mayur; Jain, Aditya; Singh, Sahib; Ali, Hassam; Vinayek, Rakesh; Aswath, Ganesh; Sharma, Neil; Inamdar, Sumant; Facciorusso, Antonio; Medicine, School of Medicine
    Pancreaticobiliary diseases can lead to significant morbidity and their diagnoses rely on imaging and endoscopy which are dependent on operator expertise. Artificial intelligence (AI) has seen a rapid uptake in the field of luminal endoscopy, such as polyp detection during colonoscopy. However, its use for pancreaticobiliary endoscopic modalities such as endoscopic ultrasound (EUS) and cholangioscopy remains scarce, with only few studies available. In this review, we delve into the current evidence, benefits, limitations, and future scope of AI technologies in pancreaticobiliary endoscopy.