[Comprehensive diagnosis and treatment of distal biliary strictures: multidisciplinary collaboration and precision...

Distal biliary strictures (DBS) are a common and complex clinical problem in pancreaticobiliary diseases,with etiologies involving multiple factors such as inflammation,benign fibrous strictures,and malignant tumors. Differentiating between benign and malignant DBS is challenging,and clinical decision-making often requires a collaborative approach involving imaging,endoscopic techniques,histopathology,and molecular diagnostics. In recent years,with the development of endoscopic ultrasound-guided fine-needle aspiration/biopsy,endoscopic retrograde cholangiopancreatography biopsy,molecular biomarkers,radiomics,and artificial intelligence,the accuracy of etiological diagnosis of DBS has significantly improved. Simultaneously,the multidisciplinary team (MDT) approach has gradually become the standard procedure. This article systematically describes the etiology,diagnostic process, and treatment strategies of DBS,focusing on the crucial role of precision surgery within the MDT framework,aiming to promote the standardization and homogenization of clinical diagnosis and treatment.