The role of peroral cholangioscopy in evaluating indeterminate biliary strictures

Nasim Parsa, Mouen A. Khashab

Research output: Contribution to journalReview articlepeer-review


Biliary strictures are considered indeterminate when the initial radiologic evaluation and endoscopic retrograde cholangiopancreatography with brush cytology and/or forceps biopsy do not reveal diagnostic findings. Evaluation of these strictures is challenging and often requires a multidisciplinary approach and multiple procedures. Peroral cholangioscopy allows direct visualization of these lesions and targeted tissue acquisition using miniature biopsy forceps. In the past decade, there have been significant improvements in the field of cholangioscopy. These advances have allowed higher-quality image acquisition, easy setup, operation by a single operator, easy maneuverability, and excellent targeted tissue sampling performance. However, the interpretation of cholangioscopic visual findings remains challenging. In this review, we discuss the role of peroral cholangioscopy in the evaluation of indeterminate biliary strictures.

Original languageEnglish (US)
Pages (from-to)556-564
Number of pages9
JournalClinical Endoscopy
Issue number6
StatePublished - Nov 2019


  • Bile duct disease
  • Bile duct neoplasm
  • Biliary strictures
  • Cholangiocarcinoma

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Radiology Nuclear Medicine and imaging
  • Gastroenterology


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