BILIARY TRACT: Edited by Gregory J. GoresEndoscopic ultrasound staging of cholangiocarcinomaLevy, Michael J.a; Heimbach, Julie K.b; Gores, Gregory J.aAuthor Information aDivision of Gastroenterology and Hepatology bDepartment of Transplant Surgery, Mayo Clinic, Rochester, Minnesota, USA Correspondence to Michael J. Levy, MD, Division of Gastroenterology and Hepatology, Mayo Clinic, 200 First Street SW, Rochester, Minnesota 55905, USA. Tel: +1 507 266 6931; fax: +1 507 266 3939; e-mail: [email protected] Current Opinion in Gastroenterology: May 2012 - Volume 28 - Issue 3 - p 244-252 doi: 10.1097/MOG.0b013e32835005bc Buy Metrics Abstract Purpose of review 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. Recent findings 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. Summary 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. © 2012 Lippincott Williams & Wilkins, Inc.