“BENIGN AND MALIGNANT BILIARY STRICTURES: A COMPREHENSIVE REVIEW OF DIAGNOSIS AND TREATMENT.”

Abstract

 Biliary strictures are characterized by a narrowing of the bile ducts that leads to obstruction and may arise from either benign or malignant conditions. Establishing an accurate diagnosis remains essential yet difficult, as benign and malignant strictures often present with overlapping clinical and radiological features. This review outlines a comprehensive diagnostic framework that combines biochemical markers, imaging techniques, and advanced endoscopic methods to differentiate between these etiologies. Commonly utilized imaging modalities, including ultrasound, MRI/MRCP, and contrast-enhanced computed tomography (CECT), each offer specific benefits and limitations. In addition, endoscopic approaches such as ERCP and EUS play a pivotal role in tissue sampling, thereby improving diagnostic precision, particularly in cases of indeterminate or complex strictures. Emerging technologies, including artificial intelligence and novel endoscopic innovations, demonstrate significant potential in enhancing diagnostic accuracy and minimizing uncertainties. Overall, this review highlights the importance of a multidisciplinary approach to optimize diagnostic pathways and facilitate timely and appropriate management of patients with biliary strictures.