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The diagnosis of biliary strictures in clinical practice can be challenging. Discriminating between benign and malignant biliarystrictures is important to prevent the morbidity and mortality associated with incorrect diagnoses. Missing a malignant biliarystricture may delay surgery, resulting in poor prognostic outcomes. Conversely, it has been demonstrated that approximately20% of patients who undergo surgery for suspected biliary malignancies have a benign etiology on histopathology. Traditionaltissue sampling using endoscopic retrograde cholangiography does not always produce a definitive diagnosis, with a considerableproportion of cases remaining as indeterminate biliary strictures. Recent advances in endoscopic techniques have the potential toimprove the diagnostic and prognostic accuracy of biliary strictures.