Clues to Determining Malignancy During Cholangioscopy

Since cholangioscopy has entered mainstream endoscopic practice, numerous investigations have been aimed at identifying specific cholangioscopic findings that predict malignancy in patients with indeterminate biliary strictures. Several classifications of cholangioscopic findings have been developed to try to simplify this vexing problem, but none has achieved widespread adoption.

Now, researchers in Ecuador have conducted a retrospective, single-center, cohort study to determine if detection of neovasculature (“tumor vessels”) during cholangioscopy can distinguish neoplastic from nonneoplastic bile duct lesions in 95 patients who underwent digital cholangioscopy for strictures.

Of these patients, 68% were found to have neovascularization at …