The Role of Endoscopy in the Diagnosis of Bile Duct Strictures

Stenosis of the bile ducts is a relatively common disease arising from benign or more often malignant causes. As a result of stenosis, bile flow is interrupted, obstructive jaundice in some cases leads to inflammation of the bile ducts. The decision on the etiology of stenosis is crucial and is made on the basis of a summary of the clinical picture and the findings of laboratory and imaging examinations. Endoscopy plays a crucial role in the diagnosis of stenosis. Endoscopic retrograde cholangiography and endoscopic ultrasonography allow not only to macroscopically evaluate the stenosis, but also to obtain a tissue sample for cytological or histological examination. Given that the majority of patients with tumor stenosis require a definitive diagnosis for their subsequent treatment, histopathological diagnosis is absolutely essential. Cholangioscopy currently provides the most accurate assessment of the nature of the stenosis. The still limited sensitivity of imaging examinations could be increased in the future by artificial intelligence methods.