title: Endoscopic ultrasound staging of cholangiocarcinoma.
abstract: OBJECTIVE
  Cholangiocarcinoma is a malignancy arising from biliary tract epithelium that is increasing in incidence and is associated with a poor prognosis. The difficulty in diagnosis and relatively poor staging accuracy complicate management. In this review we examine the utility of endoscopic ultrasound (EUS), which is increasingly used in this setting to overcome the limitations of other imaging and biopsy techniques.
  
  
  RESULTS
  Inherent limitations of current approaches to cholangiocarcinoma diagnosis and staging have driven the pursuit of new technologies including EUS. However, there remains a relative paucity of data and some uncertainty as to the role of EUS within the diagnostic algorithm for patients with suspected or known cholangiocarcinoma. In addition, there is controversy regarding the role of EUS fine-needle aspiration, the findings of which may enhance diagnosis, but may also predispose to tumor seeding and iatrogenic upstaging.
  
  
  CONCLUSIONS
  An emerging indication for EUS is the diagnosis and staging of cholangiocarcinoma. This information may be used to help guide patient care and improve outcomes, but may also be employed in a manner that risks patient well being.
authors.affiliation: Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota 55905, USA. levy.michael@mayo.edu
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Levy
authors.forename: Julie K
authors.initials: JK
authors.lastname: Heimbach
authors.forename: Gregory J
authors.initials: GJ
authors.lastname: Gores
mesh_terms: D001650:Bile Duct Neoplasms / Q000175:diagnosis / Q000473:pathology*; D001653:Bile Ducts, Intrahepatic / Q000473:pathology; D044963:Biopsy, Fine-Needle / Q000009:adverse effects*; D018281:Cholangiocarcinoma / Q000175:diagnosis / Q000473:pathology*; D055088:Early Detection of Cancer; D019160:Endosonography / Q000379:methods; D005260:Female; D006801:Humans; D007049:Iatrogenic Disease; D008297:Male; D009366:Neoplasm Seeding; D009367:Neoplasm Staging; D018570:Risk Assessment; D012680:Sensitivity and Specificity