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Next-generation sequencing of bile duct specimens is promising, but prospective, multi-institutional, comprehensive DNA/RNA analysis has been lacking. The study evaluates whether real-time, prospective DNA/RNA-based next-generation sequencing improves early diagnosis and management of neoplastic bile duct strictures through a 6-year, multi-institutional approach.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/dnarna-based-next-generation-sequencing-improves-the-early-diagnosis-and-management-of-neoplastic-bile-duct-strictures-a-6-year-prospective-multi-institutional-real-time-study/354569/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/dnarna-based-next-generation-sequencing-improves-the-early-diagnosis-and-management-of-neoplastic-bile-duct-strictures-a-6-year-prospective-multi-institutional-real-time-study/354569.png","ImageObject",300,407,{"name":92,"@type":93},"kopisore","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-28","2026-09-22",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",14,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"Why is distinguishing benign from neoplastic bile duct strictures challenging?","Question",{"text":113,"@type":114},"Because standard pathologic assessment of ERCP-obtained specimens has limited sensitivity, particularly for patients with primary sclerosing cholangitis.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"What gap does the study address in bile duct specimen sequencing?",{"text":118,"@type":114},"A prospective, multi-institutional, comprehensive DNA/RNA analysis had been lacking despite encouraging results from next-generation sequencing approaches.",{"name":120,"@type":111,"acceptedAnswer":121},"What is the study design and duration?",{"text":122,"@type":114},"A 6-year, prospective, multi-institutional, real-time study evaluating DNA/RNA-based next-generation sequencing for early diagnosis and management of neoplastic bile duct strictures.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},354569,1790252695,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":140,"language":141,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":142,"faqs":143,"seo_title":144,"seo_description":67,"update_tm":145,"read_time":146},962090880963,"https://ap-avatar.wpscdn.com/davatar_6f874abed73319feea01a86fa6f0fab8","Author Manuscript Author Manuscript Author Manuscript Author Manuscript  \n\n| | HHS Public Access\u003Cbr>Author manuscript\u003Cbr>Gastroenterology. Author manuscript; available in PMC 2026 August 08. |\n| --- | --- |\n\nPublished in final edited form as:  \nGastroenterology. 2026 August ; 171(2): 325–341. doi:10.1053/j.gastro.2026.02.040 .  \nThis is an open access article under the CC BY license ([http://creativecommons.org/licenses/by/4.0/](http://creativecommons.org/licenses/by/4.0/)).  \nCorrespondence: Address correspondence to: Adam Slivka, MD, PhD, Division of Gastroenterology, Hepatology and Nutrition, Department of Medicine, University of Pittsburgh Medicine Center, 200 Lothrop Street-PUH, M2, C Wing, Pittsburgh, Pennsylvania [15213. slivkaa@upmc.edu](15213. slivkaa@upmc.edu); or Nisa Kubiliun, MD, Division of Digestive and Liver Diseases, Department of Internal Medicine, University of Texas Southwestern, 1801 Inwood Road, 6th Floor, Suite 102, Dallas, Texas [75390. nisa.kubiliun@utsouthwestern.edu](75390. nisa.kubiliun@utsouthwestern.edu); or Aatur D. Singhi, MD, PhD, UPMC Presbyterian Hospital, 200 Lothrop Street, Room A616.2, Pittsburgh, Pennsylvania 15213. [singhiad@upmc.edu](singhiad@upmc.edu).  \nCRediT Authorship Contributions  \nRohit Das, MD (Data curation: Equal; Formal analysis: Equal; Writing – original draft: Equal; Writing – review & editing: Equal) Jeffrey Kleinberger, MD PhD (Data curation: Equal; Formal analysis: Equal; Writing original draft: Equal; Writing – review &  \nediting: Equal)  \nTarek Sawas, MD (Data curation: Equal; Formal analysis: Equal; Writing – original draft: Equal; Writing – review & editing: Equal) Abigail I. Wald, PhD (Data curation: Equal; Formal analysis: Equal; Writing – original draft: Equal; Writing – review & editing: Equal)  \nRobert Bubar, MD (Data curation: Equal; Formal analysis: Equal)  \nHarkirat Singh, MD (Data curation: Equal; Formal analysis: Equal)  \nJennifer Chennat, MD (Data curation: Equal; Formal analysis: Equal)  \nAsif Khalid, MD (Data curation: Equal; Formal analysis: Equal)  \nStephanie L. Romutis, MD (Data curation: Equal; Formal analysis: Equal)  \nMordechai Rabinovitz, MD (Data curation: Equal; Formal analysis: Equal)  \nAnna Tavakkoli, MD (Data curation: Equal; Formal analysis: Equal)  \nKimberly J. Fairley, DO (Data curation: Equal; Formal analysis: Equal)  \nBrian A. Boone, MD (Data curation: Equal; Formal analysis: Equal)  \nSavreet Sarkaria, MD (Data curation: Equal; Formal analysis: Equal)  \nJohn Nasr, MD (Data curation: Equal; Formal analysis: Equal)  \nNikhil R. Thiruvengadam, MD (Data curation: Equal; Formal analysis: Equal)  \nCharles Gabbert, MD (Data curation: Equal; Formal analysis: Equal)  \nSultan Mahmood, MD (Data curation: Equal; Formal analysis: Equal)  \nAhmed A. Messallam, MD (Data curation: Equal; Formal analysis: Equal)  \nMihajlo Gjeorgjievski, MD (Data curation: Equal; Formal analysis: Equal)  \nMarkus Goldschmiedt, MD (Data curation: Equal; Formal analysis: Equal)  \nShyam Thakkar, MD (Data curation: Equal; Formal analysis: Equal)  \nThomas Tielleman, MD (Data curation: Equal; Formal analysis: Equal)  \nMohannad Dugum, MD (Data curation: Equal; Formal analysis: Equal)  \nJon Reich, MD (Data curation: Equal; Formal analysis: Equal)  \nShailendra Singh, MD (Data curation: Equal; Formal analysis: Equal)  \nRandall E. Brand, MD (Data curation: Equal; Formal analysis: Equal)  \nKevin McGrath, MD (Data curation: Equal; Formal analysis: Equal)  \nKenneth Fasanella, MD (Data curation: Equal; Formal analysis: Equal)  \nAnne Marie Lennon, MD (Data curation: Equal; Formal analysis: Equal)  \nRekha Reddy, MD (Data curation: Equal; Formal analysis: Equal)  \nRoshan Shrestha, MD (Data curation: Equal; Formal analysis: Equal)  \nDaniel J. Ellis, MD (Data curation: Equal; Formal analysis: Equal)  \nSara A. Singhi, None (Data curation: Equal; Formal analysis: Equal)  \nTerrence Lee, MD (Data curation: Equal; Formal analysis: Equal)  \nPeter S. Kay, MD (Data curation: Equal; Formal analysis: Eq","cbCaie3LdOBG3GJh","https://ap.wps.com/l/cbCaie3LdOBG3GJh","pdf",2258585,32,"English","# Abstract\n## Background & Aims\n## Study focus","[{\"question\":\"Why is distinguishing benign from neoplastic bile duct strictures challenging?\",\"answer\":\"Because standard pathologic assessment of ERCP-obtained specimens has limited sensitivity, particularly for patients with primary sclerosing cholangitis.\"},{\"question\":\"What gap does the study address in bile duct specimen sequencing?\",\"answer\":\"A prospective, multi-institutional, comprehensive DNA/RNA analysis had been lacking despite encouraging results from next-generation sequencing approaches.\"},{\"question\":\"What is the study design and duration?\",\"answer\":\"A 6-year, prospective, multi-institutional, real-time study evaluating DNA/RNA-based next-generation sequencing for early diagnosis and management of neoplastic bile duct strictures.\"}]","DNA/RNA-Based Next-Generation Sequencing Improves the Early Diagnosis and Management of Neoplastic Bile Duct Strictures: A 6-Year, Prospective, Multi-Institutional, Real-Time Study | PDF",1790112024,81]