Endoscopic Approaches to Biliary Neoplasms

Biliary tract neoplasms comprise a heterogeneous group of malignancies associated with diagnostic complexity, and high morbidity and mortality. Hence, timely diagnosis, accurate staging, and effective therapeutic modalities are crucial to patient outcomes. Endoscopy plays is crucial in the multidisciplinary management of biliary neoplasms including cholangiocarcinoma, gallbladder carcinoma, ampullary neoplasms, and intraductal papillary neoplasms of the bile duct. Diagnostically, endoscopy allows for fluoroscopic mapping, endoscopic retrograde cholangiopancreatography-based tissue acquisition, direct visualization with cholangioscopy, and detailed lesion evaluation with endoscopic ultrasound. Therapeutically, biliary stenting, endoscopic ultrasound-guided biliary drainage, gastroenterostomy, and intraductal ablative therapies can be used in managing biliary neoplasms.