Retrospective Study
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Feb 14, 2017; 23(6): 1044-1050
Published online Feb 14, 2017. doi: 10.3748/wjg.v23.i6.1044
Eosinophilic cholangitis is a potentially underdiagnosed etiology in indeterminate biliary stricture
Dirk Walter, Sylvia Hartmann, Eva Herrmann, Jan Peveling-Oberhag, Wolf O Bechstein, Stefan Zeuzem, Martin-Leo Hansmann, Mireen Friedrich-Rust, Jörg G Albert
Dirk Walter, Stefan Zeuzem, Mireen Friedrich-Rust Department of Internal Medicine I, Johann Wolfgang Goethe-University Hospital, 60590 Frankfurt, Germany
Sylvia Hartmann, Martin-Leo Hansmann, Dr. Senckenberg Institute for Pathology, Johann Wolfgang Goethe-University Hospital, 60590 Frankfurt, Germany
Eva Herrmann, Institute of Biostatistics and Mathematical Modeling, Johann Wolfgang Goethe-University Hospital, 60590 Frankfurt, Germany
Jan Peveling-Oberhag, Jörg G Albert, Department for Gastroenterology, Hepatology and Endocrinology, Robert-Bosch Hospital, 70376 Stuttgart, Germany
Wolf O Bechstein, Department of General and Visceral Surgery, Johann Wolfgang Goethe-University Hospital, 60590 Frankfurt, Germany
Author contributions: Walter D and Albert JG designed the concept of the study; Data were gathered by Walter D, Peveling-Oberhag J, Bechstein WO, Zeuzem S and Friedrich-Rust M; Hartmann S and Hansmann ML performed histopathological review; Statistical analysis was performed from Herrmann E; The manuscript was drafted by Walter D, Hartmann S, Peveling-Oberhag J and Albert JG; all authors critically revised the manuscript.
Institutional review board statement: The study protocol was approved by the institutional review board (No. 478/15) of the local ethics committee of the University Hospital Frankfurt.
Informed consent statement: Patient informed consent was waived due to the retrospective design of the study.
Conflict-of-interest statement: The authors have no conflicts of interest to declare or other disclosures of record.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Correspondence to: Dr. Dirk Walter, Department of Internal Medicine I, Johann Wolfgang Goethe-University Hospital, Theodor-Stern-Kai 7, 60590 Frankfurt, Germany.
Telephone: +49-69-63015122 Fax: +49-69-63016448
Received: October 6, 2016
Peer-review started: October 10, 2016
First decision: October 20, 2016
Revised: November 17, 2016
Accepted: January 11, 2017
Article in press: January 11, 2017
Published online: February 14, 2017
Core Tip

Core tip: To differentiate benign from malignant disease in indeterminate biliary strictures (IBS) is crucial for clinical management. To date, data on eosinophilic cholangitis (EC) as a potential cause of IBS are lacking. In this retrospective study, we demonstrate that EC occurs in up to 30% of patients presenting with IBS and unclear clinical and histopathological findings at the end of diagnostic work-up. We thereby demonstrate that EC is a potentially underdiagnosed benign disease, which has to be considered in differential diagnoses of IBS to prevent these patients from surgery.