Editorial
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World J Gastroenterol. Sep 14, 2011; 17(34): 3864-3869
Published online Sep 14, 2011. doi: 10.3748/wjg.v17.i34.3864
Update of cholangioscopy and biliary strictures
Marcus W Chin, Michael F Byrne
Marcus W Chin, Department of Gastroenterology and Hepatology, Vancouver General Hospital, Amy and Athelstan Saw Fellow, University of Western Australia, Perth 6009, Australia
Michael F Byrne, Department of Gastroenterology and Hepatology, Vancouver General Hospital, University of British Columbia, Vancouver V5Z1M9, Canada
Author contributions: Byrne MF and Chin MW contributed equally to this work; Chin MW and Byrne MF contributed research and wrote the paper.
Correspondence to: Michael F Byrne, Clinical Professor, Department of Gastroenterology and Hepatology, Vancouver General Hospital, University of British Columbia, 5135-2775 Laurel St Vancouver, British Columbia, Vancouver V5Z1M9, Canada. michael.byrne@vch.ca
Telephone: +1-604-8755640 Fax: +1-604-8755447
Received: August 16, 2010
Revised: January 15, 2011
Accepted: January 22, 2011
Published online: September 14, 2011
Abstract

Cholangioscopy remains another modality in the investigation of biliary strictures. At cholangioscopy, the “tumour vessel” sign is considered a specific sign for malignancy. Through its ability to not only visualise mucosa, but to take targeted biopsies, it has a greater accuracy, sensitivity and specificity for malignant strictures than endoscopic retrograde cholangiopancreatography guided cytopathological acquisition. Cholangioscopy however, is time consuming and costly, requires greater technical expertise, and should be reserved for the investigation of undifferentiated strictures after standard investigations have failed.

Keywords: Biliary strictures; Cholangioscopy; Endoscopic retrograde cholangiopancreatography; Endoscopy; Cholangiocarcinoma