ASO Author Reflections: Hilar Biliary Strictures—A Persistent Diagnostic and Management Dilemma

Excerpt

Most biliary strictures at the hepatic hilum are caused by perihilar cholangiocarcinoma (PHC), but up to 15% of patients who undergo resection for presumed PHC are found to have benign disease. In 1985, Hadjis et al. termed this phenomenon the “malignant masquerade,” which remains a clinical dilemma because of suboptimal diagnostic tools to differentiate benign from malignant biliary strictures.^1,2 Because of this dilemma, current practice guidelines recommend surgical resection for presumed PHC in patients with indeterminate hilar strictures.³ The present study was designed to determine factors that can distinguish benign from malignant causes of hilar obstruction and long-term outcomes after surgery.⁴ …