病因不明的胆道狭窄对内窥镜医师构成了诊断挑战。尽管技术进步,诊断胆道狭窄的恶性肿瘤通常需要多种手术。建议评估的分级，使用开发和评估（GRADE）框架来严格审查和综合有关用于诊断未确定胆道狭窄的策略的现有文献。使用对每种诊断方式的系统评价和荟萃分析，包括透视引导活检，刷细胞学,胆道镜检查,和内窥镜超声细针穿刺或活检，美国胃肠内镜学会(ASGE)实践标准委员会就用于诊断病因不明的胆道狭窄的方法提供了本指南.本文件总结了等级分析中使用的方法，以提出建议，而“摘要和建议”文件包含我们的调查结果和最终建议的简明摘要。
Biliary strictures of undetermined etiology pose a diagnostic challenge for endoscopists. Despite advances in technology, diagnosing malignancy in biliary strictures often requires multiple procedures. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework was used to rigorously review and synthesize the available literature on strategies used to diagnose undetermined biliary strictures. Using a systematic review and meta-analysis of each diagnostic modality, including fluoroscopic-guided biopsy sampling, brush cytology, cholangioscopy, and EUS-guided FNA or fine-needle biopsy sampling, the American Society for Gastrointestinal Endoscopy Standards of Practice Committee provides this
guideline on modalities used to diagnose biliary strictures of undetermined etiology. This document summarizes the methods used in the GRADE analysis to make recommendations, whereas the accompanying article subtitled \"Summary and Recommendations\" contains a concise summary of our findings and final recommendations.
