In Expert review of gastroenterology & hepatology
INTRODUCTION : Cholangiocarcinoma, a primary malignancy of the epithelial cells of the bile ducts, has shown to have increasing incidence rates globally. Many of the current advances aim to improve the accuracy of differentiation between benign biliary strictures and cholangiocarcinoma which include endoscopic techniques, devices, image processing and the use of genomic sequencing in acquired specimens.
AREAS COVERED : In this review, the authors explore the historical timeline of changes leading to modern management of cholangiocarcinoma, with special emphasis on endoscopic modalities and novel therapeutic interventions. The authors also expand on the strengths and short comings of endoscopic diagnostics, techniques in biliary drainage, and finally discuss potential areas to focus for future research and development.
EXPERT OPINION : Despite the advances in diagnosis and management of cholangiocarcinoma, there remain multiple tasks that are still awaiting to be completed. Next-generation sequencing in the diagnosis of cholangiocarcinoma needs to be further tested, validated, and easily obtainable. Other innovative diagnostic modalities, such as the use of artificial intelligence in cholangioscopy, may provide an effective complementary modality to existing techniques. A consensus on biliary drainage needs to be defined and account for longevity and patient convenience.
Nakshabandi Ahmad Al, Lee Jeffrey H
2023-Jan-23
Biliary strictures, Cholangiocarcinoma, Cholangioscopy, ERCP, EUS, Next-generation DNA sequencing
