Single-operator cholangioscopy-guided biopsy of indeterminate bile duct strictures - Work in progress.

Determining an accurate diagnosis in indeterminate biliary strictures is challenging with historically low sensitivity of 50-60% as all presently available diagnostic modalities possess some degree of inherent limitations.1-3 However, the development of the second-generation single-operator cholangioscopy system (SpyGlassDS, Boston Scientific Corp.) has resulted in a significant improvement in the diagnostic sensitivity to 75-85%, and we have recently shown in a randomized trial that an accurate diagnosis can be established in 90% of patients with indeterminate biliary strictures.4,5.