Cholangioscopy or Conventional Techniques for Indeterminate Biliary Stenosis

Inclusion Criteria:

• Presence of intra- or extrahepatic biliary stenosis, involving the main bile ducts: common hepatic duct, right and left hepatic ducts
• Presence of clinical jaundice and / or biological cholestasis (GGT> 3N)
• Absence of visible mass near the biliary stenosis after initial morphological assessment by abdominal CT scan, MRI with biliary sequences.
• Endoscopic ultrasound performed and not having allowed the acquisition of material of diagnostic interest by guided puncture of the lesion.
• No history of ERCP in the 6 months preceding inclusion and no biliary prosthesis (plastic or metal) in place at the time of inclusion
• Collegial validation of the need for a formal diagnosis of indeterminate biliary stenosis in order to guide therapeutic management
• Patients aged 18 to 85
• Patient who gave his consent to participate in the study
• No contraindication to anesthesia (ASA 1, 2,3)
• Patient affiliated to a social security scheme (beneficiary or beneficiary)
• Absence of pregnancy and current contraception in women of childbearing age

Exclusion Criteria:

• Presence of a manifest tissue mass in relation to the biliary stenosis on CT and / or MRI imaging.
• Very strong presumption of the etiological diagnosis of biliary stenosis given the history (history, background): i.e. liver surgery, cholecystectomy, autoimmunity
• History of ERCP and / or percutaneous biliary drainage in the 6 months preceding inclusion
• Presence of a plastic or metal biliary prosthesis in place at the time of inclusion
• History of cephalic duodeno-pancreatectomy or hepatico-jejunal anastomosis
• Non-passable stenosis of the main bile duct
• Severe coagulopathy, thrombocytopenia <75,000 G / L, treatment with clopidogrel cannot be interrupted even temporarily
• Anesthetic contraindication (ASA 4)
• Inability to obtain informed consent
• person deprived of liberty