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Why is it so difficult to determine the nature of isolated biliary strictures? In patients with no history of biliary surgery, most bile duct strictures have to be considered malignant until proven otherwise. This usually leads to extensive usage of diagnostic imaging—in many cases even to explorative laparotomy. Furthermore, we usually have a “luxury problem”: doctors have to choose the appropriate imaging technique out of the wide range of endoscopic and radiological modalities. For this purpose, doctors should have information about each technique. In a multimodal approach, we prospectively analysed sensitivity and specificity for differentiation between malignant and benign strictures, penetration into surrounding tissues, vascular invasiveness and staging of lymph node.
We included patients with jaundice of unknown aetiology and suspected biliary stricture. According to the study protocol, patients underwent diagnostic laparotomy; alternatively, a long follow-up of more than 12 months …
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