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Updated: May 15, 2026
07:44
Endoscopic Ultrasound-Guided Biliary Drainage: Endoscopic Ultrasound-Guided Hepaticogastrostomy in Malignant Biliary Obstruction
Published on: March 25, 2022
Clinicopathological features of benign biliary strictures masquerading as biliary malignancy
Toshifumi Wakai1, Yoshio Shirai, Jun Sakata
1Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan. wakait@med.niigata-u.ac.jp
The American Surgeon
|December 26, 2012
Summary
Differentiating benign from malignant biliary strictures is challenging. This study found no reliable preoperative indicators, reinforcing surgical resection for presumed biliary malignancy.
Area of Science:
- Hepatobiliary Surgery
- Gastroenterology
- Sclerosing Cholangitis
Background:
- Distinguishing benign from malignant biliary strictures poses diagnostic challenges.
- A significant percentage of presumed malignant strictures are benign upon histological examination.
Purpose of the Study:
- To evaluate clinicopathological features of benign biliary strictures in patients undergoing resection for presumed malignancy.
- To identify preoperative indicators for differentiating benign from malignant biliary strictures.
Main Methods:
- Retrospective analysis of 153 patients undergoing resection for presumed biliary malignancy (1990-2010).
- Histological examination and immunohistochemistry for immunoglobulin G4-positive plasma cells.
- Evaluation of preoperative clinical and radiographic data.
Main Results:
- Five patients (3.3%) had benign biliary strictures post-histology.
- No preoperative features reliably distinguished benign from malignant strictures.
- Immunoglobulin G4-related sclerosing cholangitis and nonspecific fibrosis/inflammation were identified.
Conclusions:
- Benign biliary strictures are rare but difficult to differentiate preoperatively.
- Surgical resection remains the recommended approach for presumed biliary malignancy due to diagnostic limitations.
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