Abstract：
Endoscopic ultrasonography (EUS) provides high spatial resolution and more detailed images than other diagnostic modalities. Furthermore, EUS-guided tissue acquisition (EUS-TA), such as EUS-guided fine needle aspiration or biopsy (EUS-FNA/FNB), is an indispensable tool in pancreaticobiliary disease diagnostics, supporting a conclusive pathological diagnosis. In this review, we evaluate the current status and the usefulness of EUS-TA for the diagnostics of the following biliary tract diseases: (A) biliary stricture diagnostics, (B) biliary tract cancer (BTC) itself, and (C) staging of advanced BTC. Previous reports have shown that EUS-FNA for biliary lesions is a safe procedure that is useful in differentiating biliary cancer from benign lesions and in the staging of BTC. On the other hand, the diagnostic performance of EUS-TA for bile duct lesions is reported to be similar to that of transpapillary biopsy. Overall, EUS-TA for biliary lesions may be a safe and effective method, but it should be performed with an understanding of the risk of serious adverse events such as bile leakage and peritoneal dissemination of cancer. It is recommended for distal biliary stricture lesions for which endoscopic retrograde cholangiopancreatography cannot confirm the diagnosis or gallbladder lesions if they do not require the needle to pass through the biliary lumen.
摘要：
内窥镜超声检查（EUS）比其他诊断方式提供高空间分辨率和更详细的图像。此外，EUS引导的组织采集（EUS-TA），如EUS引导的细针穿刺活检（EUS-FNA/FNB），是胰胆管疾病诊断中不可或缺的工具，支持决定性的病理诊断。在这次审查中,我们评估EUS-TA在以下胆道疾病诊断中的现状和有用性：（A）胆道狭窄诊断，（B）胆道癌（BTC）本身，和(C)高级BTC的分期。先前的报道表明，用于胆道病变的EUS-FNA是一种安全的程序，可用于区分胆道癌与良性病变以及BTC的分期。另一方面,据报道,EUS-TA对胆管病变的诊断表现与经乳头活检相似.总的来说,EUS-TA治疗胆道病变可能是一种安全有效的方法,但应了解胆漏和癌症腹膜播散等严重不良事件的风险。建议用于远端胆管狭窄病变，如果内窥镜逆行胰胆管造影术不需要针头穿过胆道腔，则无法确认诊断或胆囊病变。
