The new criteria for differential diagnosis of indeterminate biliary stricture under super minimally invasive peroral cholangioscopyOACSTPCDMEDLINE

Indeterminate biliary stricture(IBS)refers to biliary stricture with an uncertain histological diagnosis^([1])and can be classified as non-neoplastic stricture or neoplastic stricture.The former is mainly caused by various inflammatory biliopancreatic diseases,congenital malformations,or postoperative bile duct injury,while the latter exists in neoplastic lesions such as cholangiocarcinoma,invasion from pancreatic cancer,and adenomas in the bile duct.Most non-neoplastic strictures can be relieved by endoscopic or conservative medical treatment,and only a few require surgical intervention.Nevertheless,radical surgery or palliative biliary drainage should be applied for neoplastic strictures according to the progression of the disease.Therefore,it is essential to obtain an accurate diagnosis for IBS in clinical work.