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Clinical approach to indeterminate biliary strictures:Clinical presentation,diagnosis,and workup

World Journal of Gastroenterology 2023年第36期29卷 5198-5210页

作者： Sujani Yadlapati Ramzi Mulki Sergio A Sánchez-Luna Ali M Ahmed Kondal Rao Kyanam Kabir Baig Shajan Peter Department of Gastroenterology and Hepatology Indiana University HospitalIndianapolisIN 46202USA Department of Gastroenterology and Hepatology University of Alabama at BirminghamBirminghamAL 35294USA

Despite advances in cross-sectional imaging and endoscopic technology,bile duct strictures remain a challenging clinical *** is crucial to make an early determination of benign or malignant nature of biliary *** diagnosis not only helps with further management but also minimizes mortality and morbidity associated with delayed *** imaging and endoscopic techniques,particularly endoscopic retrograde cholangiopancreatography(ERCP)and tissue sampling techniques play a key in establishing a *** biliary strictures(IDBSs)have no definite mass on imaging or absolute histopathological diagnosis and often warrant utilization of multiple diagnostics to ascertain an *** this review,we discuss possible etiologies,clinical presentation,diagnosis,and management of *** on available data and expert opinion,we depict an evidence based diagnostic algorithm for management of *** of focus include use of traditional tissue sampling techniques such as ERCP with brush cytology,intraductal biopsies,fluorescence in situ hybridization and flow *** 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.

关键词： Biliary strictures Indeterminate strictures Biliary sampling Cholangioscopy benign strictures Malignant strictures Indeterminate biliary strictures

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Feasibility and safety of self-expandable metal stent in nonmalignant disease of the lower gastrointestinal tract

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World Journal of Gastrointestinal Endoscopy 2020年第2期12卷 60-71页

作者： Ludovica Venezia Andrea Michielan Giovanna Condino Emanuele Sinagra Elisa Stasi Marianna Galeazzi Carlo Fabbri Andrea Anderloni Gastroenterology Unit AOU Cittàdella Salute e della Scienza TurinTurin 10100Italy Gastroenterology and Digestive Endoscopy Unit Ospedale Santa ChiaraTrento 38122Italy Gastroenterology Unit Azienda Ospedaliera S.S.Antonio e Biagio e Cesare ArrigoAlessandria 15121Italy Gastroenterology and Endoscopy Unit Fondazione Istituto Giuseppe GiglioContrada Pietra Pollastra PisciottoCefalù90015Italy Euro-Mediterranean Institute of Science and Technology(IEMEST) Palermo 90100Italy Gastroenterology Unit Department of Medicine“Vito Fazzi”HospitalLecce 73100Italy University of Milano-Bicocca School of Medicine and SurgeryMonza 20052Italy Gastroenterology and Digestive Endoscopy Unit Forlì-CesenaAzienda U.S.L.RomagnaOspedale G.Morgagni-L.PierantoniCesena 200868Italy Digestive Endoscopy Unit Humanitas Research HospitalMilan 20100Italy

In recent years,self-expandable metal stents(SEMSs)have been employed to treat benign gastrointestinal strictures secondary to several conditions:Acute diverticulitis,radiation colitis,inflammatory bowel disease(IBD),and postanastomotic leakages and *** applications include endometriosis and fistulas of the lower gastrointestinal *** it may be technically feasible to proceed to stenting in the aforementioned benign diseases of the lower gastrointestinal tract,the outcome has been reported to be *** fact,in some settings(such as complicated diverticulitis and postsurgical anastomotic strictures),stenting seems to have a limited evidence-based benefit as a bridge to surgery,while in other settings(such as endometriosis,IBD,radiation colitis,etc.),even society guidelines are not able to guide the endoscopist through decisional algorithms for SEMS *** aim of this narrative paper is to review the scientific evidence regarding the use of SEMSs in nonmalignant diseases of the lower gastrointestinal tract,both in adult and pediatric settings.

关键词： Self-expandable metal stents Lower gastrointestinal tract benign strictures

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