The article was published in 2008. The authors reviewed the literature up to July 2007. They reached the conclusion that positive biopsy is not required to diagnose extrahepatic CC. That was before the emergence of SpyGlass exam. I’m not sure if SpyGlass biopsy is accurate enough to change the conclusion reached in the article.
Here’s another good article closely related to the other two.
Eli found this article,which may help patients who have extrahepetic cholangiocarcinoma on their surgery decision making process through understanding how the doctors makes their decision on what and how to operated on ECCA.
the link is below.