{"id":4926,"date":"2021-05-28T09:00:53","date_gmt":"2021-05-28T09:00:53","guid":{"rendered":"https:\/\/endoscopiaterapeutica.net\/pt\/uncategorized\/endoscopia-no-colangiocarcinoma\/"},"modified":"2021-09-16T13:55:45","modified_gmt":"2021-09-16T13:55:45","slug":"endoscopia-no-colangiocarcinoma","status":"publish","type":"post","link":"https:\/\/endoscopiaterapeutica.net\/pt\/assuntosgerais\/endoscopia-no-colangiocarcinoma\/","title":{"rendered":"Endoscopia no colangiocarcinoma"},"content":{"rendered":"<p><span style=\"font-weight: 400;\">A obstru\u00e7\u00e3o biliar maligna \u00e9 uma condi\u00e7\u00e3o desafiadora, exigindo uma abordagem multimodal para diagn\u00f3stico e tratamento. O diagn\u00f3stico precoce \u00e9 dif\u00edcil de se estabelecer, pois a obstru\u00e7\u00e3o biliar costuma aparecer apenas em est\u00e1gios avan\u00e7ados, consequentemente, na maioria dos pacientes (70%), os tumores s\u00e3o irressec\u00e1veis no momento do diagn\u00f3stico.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">A maioria dos casos \u00e9 espor\u00e1dica, mas diferentes fatores que causam inflama\u00e7\u00e3o cr\u00f4nica da \u00e1rvore biliar, como colangite esclerosante prim\u00e1ria (CEP) e infec\u00e7\u00f5es cr\u00f4nicas, est\u00e3o frequentemente implicados. Outras condi\u00e7\u00f5es subjacentes s\u00e3o doen\u00e7a hep\u00e1tica polic\u00edstica, doen\u00e7a de Caroli e cistos de col\u00e9doco e contamina\u00e7\u00e3o por fasc\u00edola hep\u00e1tica.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Deve-se suspeitar com base em achados cl\u00ednicos, como dor abdominal no quadrante superior direito e al\u00e9m de sintomas de obstru\u00e7\u00e3o biliar (s\u00edndrome ict\u00e9rica). A resson\u00e2ncia magn\u00e9tica \u00e9 o exame de escolha para avaliar a extens\u00e3o da doen\u00e7a. Imagens ponderadas em T2, as quais exibem fluido com alto sinal de intensidade (branco), podem definir o n\u00edvel de estenose biliar e identificar caracter\u00edsticas malignas, como estenoses com mais de 1 cm de comprimento, margens irregulares e acotovelamentos.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">A sobrevida m\u00e9dia ap\u00f3s ressec\u00e7\u00f5es R0 varia entre 1 e 4 anos, sendo as recorr\u00eancias nesses casos de 50 a 70%. Al\u00e9m disso, a sobrevida nos tumores irressec\u00e1veis varia de 5 a 9 meses [1].<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Abaixo, a classifica\u00e7\u00e3o de Bismuth-Corlette, que divide esses tumores de acordo com sua localiza\u00e7\u00e3o:<\/span><\/p>\n<p><a href=\"https:\/\/endoscopiaterapeutica.net\/pt\/wp-content\/uploads\/2021\/08\/Figura1.bmp\" data-rel=\"penci-gallery-image-content\" ><img fetchpriority=\"high\" decoding=\"async\" class=\"aligncenter wp-image-13931 size-full\" title=\"Classifica\u00e7\u00e3o de Bismuth-Corlette\" src=\"https:\/\/endoscopiaterapeutica.net\/pt\/wp-content\/uploads\/2021\/08\/Figura1.bmp\" alt=\"Classifica\u00e7\u00e3o de Bismuth-Corlette\" width=\"661\" height=\"386\" \/><\/a><\/p>\n<p style=\"text-align: center;\"><span style=\"font-weight: 400;\">Figura 1: classifica\u00e7\u00e3o de Bismuth-Corlette<\/span><\/p>\n<p><span style=\"font-weight: 400;\">A <\/span><a href=\"https:\/\/endoscopiaterapeutica.net\/pt\/\"><span style=\"font-weight: 400;\">endoscopia<\/span><\/a><span style=\"font-weight: 400;\"> no colangiocarcinoma poder\u00e1 ter tr\u00eas pap\u00e9is de acordo com o est\u00e1dio da doen\u00e7a:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">diagn\u00f3stico por imagem;<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">obten\u00e7\u00e3o de amostra tecidual;<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">palia\u00e7\u00e3o.<\/span><\/li>\n<\/ul>\n<h2><b>Colangiopancreatografia endosc\u00f3pica retr\u00f3grada (CPRE)<\/b><\/h2>\n<p><span style=\"font-weight: 400;\">Principal exame do arsenal endosc\u00f3pico com fun\u00e7\u00f5es tanto diagn\u00f3sticas como terap\u00eauticas.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">O escovado citol\u00f3gico apresenta sensibilidade de 26 a 72%, e a bi\u00f3psia de 15 a 100%, sendo que a acur\u00e1cia, quando utilizados em conjunto, chega a 75% [2].<\/span><\/p>\n<p><a href=\"https:\/\/endoscopiaterapeutica.net\/pt\/wp-content\/uploads\/2021\/08\/Figura2.jpg\"><br \/>\n<\/a><a href=\"https:\/\/endoscopiaterapeutica.net\/pt\/wp-content\/uploads\/2021\/08\/Figura2.jpg\" data-rel=\"penci-gallery-image-content\" ><img decoding=\"async\" class=\"aligncenter wp-image-13932 size-full\" title=\"CPRE em colangiocarcinoma hilar\" src=\"https:\/\/endoscopiaterapeutica.net\/pt\/wp-content\/uploads\/2021\/08\/Figura2.jpg\" alt=\"CPRE em colangiocarcinoma hilar\" width=\"661\" height=\"639\" \/><\/a><\/p>\n<p style=\"text-align: center;\"><span style=\"font-weight: 400;\">Figura 2: CPRE em colangiocarcinoma hilar<\/span><\/p>\n<p><a href=\"https:\/\/endoscopiaterapeutica.net\/pt\/wp-content\/uploads\/2021\/08\/Figura3.jpg\" data-rel=\"penci-gallery-image-content\" ><img decoding=\"async\" class=\"aligncenter wp-image-13933 size-full\" title=\"escova citol\u00f3gica\" src=\"https:\/\/endoscopiaterapeutica.net\/pt\/wp-content\/uploads\/2021\/08\/Figura3.jpg\" alt=\"escova citol\u00f3gica\" width=\"521\" height=\"374\" \/><\/a><\/p>\n<p style=\"text-align: center;\"><span style=\"font-weight: 400;\">Figura 3: escova citol\u00f3gica utilizada no caso anterior que confirmou diagn\u00f3stico<\/span><\/p>\n<h2><b>Ecoendoscopia (EUS)<\/b><\/h2>\n<p><span style=\"font-weight: 400;\">Trabalhos recentes mostram que a EUS apresenta acur\u00e1cia diagn\u00f3stica de 76%, semelhante \u00e0 CPRE nas les\u00f5es biliares. Esta deve ser especialmente realizada nas les\u00f5es distais, principalmente nos casos de d\u00favida quanto a origem biliar ou pancre\u00e1tica e nas les\u00f5es acima de 4 cm. Quando associada \u00e0 CPRE, apresenta acur\u00e1cia de at\u00e9 93% [2].<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Outra importante fun\u00e7\u00e3o da EUS \u00e9 o estadiamento linfonodal. Em um estudo realizado em pacientes com colangiocarcinoma e indica\u00e7\u00e3o de transplante hep\u00e1tico, a pun\u00e7\u00e3o de linfonodos pela EUS evidenciou o acometimento em 17% desses pacientes, evitando assim uma cirurgia desnecess\u00e1ria, devendo dessa forma fazer parte do estadiamento pr\u00e9-operat\u00f3rio [3].<\/span><\/p>\n<h2><b>Colangioscopia (SpyGlass<\/b><b>\u00ae<\/b><b>)<\/b><\/h2>\n<p><span style=\"font-weight: 400;\">Endosc\u00f3pio em \u201cminiatura\u201d utilizado atrav\u00e9s do canal de trabalho do duodenosc\u00f3pio por um operador \u00fanico, com acur\u00e1cia diagn\u00f3stica de 94%, apresenta as seguintes fun\u00e7\u00f5es [4]:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">avalia\u00e7\u00e3o visual de estenoses indeterminadas;<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">amostra tecidual atrav\u00e9s da pin\u00e7a de bi\u00f3psia pr\u00f3pria;<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">direcionamento de fio guia para palia\u00e7\u00e3o.<\/span><\/li>\n<\/ul>\n<p><a href=\"https:\/\/endoscopiaterapeutica.net\/pt\/wp-content\/uploads\/2021\/08\/Figura4.jpg\" data-rel=\"penci-gallery-image-content\" ><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter wp-image-13934 size-full\" title=\"sistema de colangioscopia SpyGlass\u00ae\" src=\"https:\/\/endoscopiaterapeutica.net\/pt\/wp-content\/uploads\/2021\/08\/Figura4.jpg\" alt=\"sistema de colangioscopia SpyGlass\u00ae\" width=\"894\" height=\"668\" \/><\/a><\/p>\n<p style=\"text-align: center;\"><span style=\"font-weight: 400;\">Figura 4: sistema de colangioscopia SpyGlass<\/span><span style=\"font-weight: 400;\">\u00ae<\/span><\/p>\n<div  id=\"_ytid_13534\"  width=\"600\" height=\"300\"  data-origwidth=\"600\" data-origheight=\"300\" data-facadesrc=\"https:\/\/www.youtube.com\/embed\/m6ogUEZOqZc?enablejsapi=1&#038;autoplay=0&#038;cc_load_policy=0&#038;cc_lang_pref=&#038;iv_load_policy=1&#038;loop=0&#038;rel=1&#038;fs=1&#038;playsinline=0&#038;autohide=2&#038;theme=dark&#038;color=red&#038;controls=1&#038;disablekb=0&#038;\" class=\"__youtube_prefs__ epyt-facade epyt-is-override  no-lazyload\" data-epautoplay=\"1\" ><img decoding=\"async\" data-spai-excluded=\"true\" class=\"epyt-facade-poster skip-lazy\" loading=\"lazy\"  alt=\"YouTube player\"  src=\"https:\/\/i.ytimg.com\/vi\/m6ogUEZOqZc\/maxresdefault.jpg\"  \/><button class=\"epyt-facade-play\" aria-label=\"Play\"><svg data-no-lazy=\"1\" height=\"100%\" version=\"1.1\" viewBox=\"0 0 68 48\" width=\"100%\"><path class=\"ytp-large-play-button-bg\" d=\"M66.52,7.74c-0.78-2.93-2.49-5.41-5.42-6.19C55.79,.13,34,0,34,0S12.21,.13,6.9,1.55 C3.97,2.33,2.27,4.81,1.48,7.74C0.06,13.05,0,24,0,24s0.06,10.95,1.48,16.26c0.78,2.93,2.49,5.41,5.42,6.19 C12.21,47.87,34,48,34,48s21.79-0.13,27.1-1.55c2.93-0.78,4.64-3.26,5.42-6.19C67.94,34.95,68,24,68,24S67.94,13.05,66.52,7.74z\" fill=\"#f00\"><\/path><path d=\"M 45,24 27,14 27,34\" fill=\"#fff\"><\/path><\/svg><\/button><\/div>\n<p>&nbsp;<\/p>\n<h2><b>Endomicroscopia confocal (Cellvizio<\/b><b>\u00ae<\/b><b>)<\/b><\/h2>\n<p><span style=\"font-weight: 400;\">Consiste em uma sonda passada atrav\u00e9s do canal de trabalho do duodenosc\u00f3pio at\u00e9 o local de estenose, realizando uma bi\u00f3psia virtual e ao vivo, apresenta uma resolu\u00e7\u00e3o at\u00e9 1000x maior se comparado ao microsc\u00f3pio \u00f3ptico padr\u00e3o.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Ap\u00f3s a inje\u00e7\u00e3o intravenosa de fluoresce\u00edna, esta se difunde atrav\u00e9s dos capilares e cora matriz extracelular do epit\u00e9lio superficial. Os n\u00facleos n\u00e3o absorvem o contraste e aparecem escuros, a diferen\u00e7a de contraste permite a an\u00e1lise arquitet\u00f4nica da mucosa superficial, ajudando a diferenciar o tecido normal do neopl\u00e1sico. Estudos demonstraram uma sensibilidade de 81 a 100% e especificidade de 61 a 88% [5].<\/span><\/p>\n<p style=\"text-align: center;\"><a href=\"https:\/\/endoscopiaterapeutica.net\/pt\/wp-content\/uploads\/2021\/08\/Figura5.jpg\" data-rel=\"penci-gallery-image-content\" ><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter wp-image-13935 size-full\" title=\"estenose biliar benigna e maligna\" src=\"https:\/\/endoscopiaterapeutica.net\/pt\/wp-content\/uploads\/2021\/08\/Figura5.jpg\" alt=\"estenose biliar benigna e maligna\" width=\"1107\" height=\"417\" \/><\/a><span style=\"font-weight: 400;\">Figura 5. A: imagem de estenose biliar benigna; B: estenose biliar maligna demonstrado pelo espessamento e aglomerados escuros.<\/span><\/p>\n<h2><b>Drenagem biliar<\/b><\/h2>\n<h3>Pr\u00e9-operat\u00f3ria<\/h3>\n<p><span style=\"font-weight: 400;\">Controversa, sendo que alguns estudos demonstraram maiores taxas de complica\u00e7\u00f5es p\u00f3s-operat\u00f3rias. Deve ser realizada nos seguintes casos [6]:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">cirurgia postergada &gt; 2 semanas;<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">quimioterapia neoadjuvante;<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">colangite;<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">icter\u00edcia sintom\u00e1tica (prurido).<\/span><\/li>\n<\/ul>\n<h3>Paliativa<\/h3>\n<p><span style=\"font-weight: 400;\">Tem como objetivo a drenagem de, pelo menos, 50% do par\u00eanquima. Em geral, o lobo direito corresponde a quase 60% do volume, enquanto o lobo esquerdo e o lobo caudado correspondem a 30% e 10%, respectivamente [7].<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Em compara\u00e7\u00e3o com a drenagem endosc\u00f3pica atrav\u00e9s da CPRE, outras cl\u00e1ssicas op\u00e7\u00f5es s\u00e3o:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">drenagem cir\u00fargica: igual sucesso e maior pat\u00eancia, por\u00e9m maiores taxas de complica\u00e7\u00f5es e mortalidade;<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">drenagem percut\u00e2nea: mais eventos adversos, repeti\u00e7\u00e3o de procedimentos, hospitaliza\u00e7\u00e3o prolongada, maior custo e desconforto do cateter externo, por\u00e9m apresenta os melhores resultados no Bismuth IV e eventualmente no Bismuth III.<\/span><\/li>\n<\/ul>\n<h3>Stent met\u00e1lico x pl\u00e1stico<\/h3>\n<p><span style=\"font-weight: 400;\">Os met\u00e1licos apresentam menor disfun\u00e7\u00e3o e necessidade de reinterven\u00e7\u00f5es, sendo optados em pacientes com expectativa de vida acima de 4 meses. Apesar da prefer\u00eancia de muitos profissionais pelo descoberto, especialmente devido \u00e0s estenoses hilares que correspondem a 60% dos casos, n\u00e3o h\u00e1 consenso na literatura. Os stents descobertos apresentam maiores taxas de obstru\u00e7\u00e3o, e os cobertos apresentam maiores taxas de migra\u00e7\u00e3o.<\/span><\/p>\n<h3>Abla\u00e7\u00e3o por radiofrequ\u00eancia<\/h3>\n<p><span style=\"font-weight: 400;\">Cateter introduzido atrav\u00e9s da CPRE, que produz energia t\u00e9rmica causando necrose tecidual tumoral, levando maior pat\u00eancia do stent e sobrevida [8].<\/span><br \/>\n<a href=\"https:\/\/endoscopiaterapeutica.net\/pt\/wp-content\/uploads\/2021\/08\/Figura6.jpg\" data-rel=\"penci-gallery-image-content\" ><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter wp-image-13936 size-full\" title=\"cateter de radiofrequ\u00eancia Habib\u00ae\" src=\"https:\/\/endoscopiaterapeutica.net\/pt\/wp-content\/uploads\/2021\/08\/Figura6.jpg\" alt=\"cateter de radiofrequ\u00eancia Habib\u00ae\" width=\"813\" height=\"418\" \/><\/a><\/p>\n<p style=\"text-align: center;\"><span style=\"font-weight: 400;\">Figura 6: cateter de radiofrequ\u00eancia Habib<\/span><span style=\"font-weight: 400;\">\u00ae<\/span><\/p>\n<h3>Drenagem biliar ecoguiada<\/h3>\n<p><span style=\"font-weight: 400;\">Alternativa normalmente reservada para casos de falha de CPRE. Entretanto, recentemente, ensaios cl\u00ednicos randomizados comparando a drenagem ecoguiada e a CPRE demonstraram taxas similares de sucesso t\u00e9cnico, cl\u00ednico, dura\u00e7\u00e3o e eventos adversos, inclusive com menor taxa de disfun\u00e7\u00e3o de stent no grupo ecoguiado.<\/span><a href=\"https:\/\/endoscopiaterapeutica.net\/pt\/wp-content\/uploads\/2021\/08\/Figura7.jpg\" data-rel=\"penci-gallery-image-content\" ><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter wp-image-13937 size-full\" title=\"endosc\u00f3pica tardia de drenagem coledocoduodenal\" src=\"https:\/\/endoscopiaterapeutica.net\/pt\/wp-content\/uploads\/2021\/08\/Figura7.jpg\" alt=\"endosc\u00f3pica tardia de drenagem coledocoduodenal\" width=\"640\" height=\"480\" \/><\/a><\/p>\n<p style=\"text-align: center;\"><span style=\"font-weight: 400;\">Figura 7: vis\u00e3o endosc\u00f3pica tardia de drenagem coledocoduodenal<\/span><\/p>\n<h2><span style=\"font-weight: 400;\">N\u00famero de stents<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Tendo em vista o objetivo de drenagem de pelo menos 50% do par\u00eanquima, o n\u00famero de stents \u00e9 relativo, por\u00e9m seguindo a regra abaixo dever\u00e1 ser atingido esse objetivo:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Bismuth I: 1 stent;<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Bismuth II, III e IV:\u2265 2 stents.<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Abaixo, um fluxograma da abordagem das obstru\u00e7\u00f5es biliares:<\/span><\/p>\n<p><a href=\"https:\/\/endoscopiaterapeutica.net\/pt\/wp-content\/uploads\/2021\/08\/Figura8.jpg\" data-rel=\"penci-gallery-image-content\" ><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter wp-image-13938 size-full\" title=\"fluxograma da abordagem das obstru\u00e7\u00f5es biliares\" src=\"https:\/\/endoscopiaterapeutica.net\/pt\/wp-content\/uploads\/2021\/08\/Figura8.jpg\" alt=\"fluxograma da abordagem das obstru\u00e7\u00f5es biliares\" width=\"753\" height=\"320\" \/><\/a><\/p>\n<h2><b>Quer saber mais sobre drenagem biliar ecoguiada? Acesse:<\/b><\/h2>\n<p><a href=\"https:\/\/endoscopiaterapeutica.net\/pt\/assuntosgerais\/drenagem-biliar-ecoguiada-breve-revisao\/\"><span style=\"font-weight: 400;\">https:\/\/endoscopiaterapeutica.net\/pt\/assuntosgerais\/drenagem-biliar-ecoguiada-breve-revisao\/<\/span><\/a><\/p>\n<p><a href=\"https:\/\/endoscopiaterapeutica.net\/pt\/casosclinicos\/coledocoduodenostomia-ecoguiada-um-procedimento-endoscopico-cirurgico\/\"><span style=\"font-weight: 400;\">https:\/\/endoscopiaterapeutica.net\/pt\/casosclinicos\/coledocoduodenostomia-ecoguiada-um-procedimento-endoscopico-cirurgico\/<\/span><\/a><\/p>\n<h3>Como citar este artigo<\/h3>\n<p><span style=\"font-weight: 400;\">Fernandez J. Endoscopia no colangiocarcinoma. Endoscopia Terap\u00eautica; 2021. Dispon\u00edvel em: https:\/\/endoscopiaterapeutica.net\/pt\/assuntosgerais\/endoscopia-no-colangiocarcinoma<\/span><\/p>\n<h3>Refer\u00eancias<\/h3>\n<ol>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Rerknimitr R, Angsuwatcharakon P, Ratanachu-ek T, et al. Asia-Pacific consensus recommendations for endoscopic and interventional management of hilar cholangiocarcinoma. J Gastroenterol Hepatol. 2013 Apr;28(4):593-607. doi: 10.1111\/jgh.12128. PMID: 23350673.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">De Moura DTH, Moura EGH, Bernardo WM, et al. Endoscopic retrograde cholangiopancreatography versus endoscopic ultrasound for tissue diagnosis of malignant biliary stricture: Systematic review and meta-analysis. Endosc Ultrasound. 2018 Jan-Feb;7(1):10-19. doi: 10.4103\/2303-9027.193597. PMID: 27824027; PMCID: PMC5838722.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Jo JH, Cho CM, Jun JH, et al; Research Group for Endoscopic Ultrasonography in KSGE. Same-session endoscopic ultrasound-guided fine needle aspiration and endoscopic retrograde cholangiopancreatography-based tissue sampling in suspected malignant biliary obstruction: A multicenter experience. J Gastroenterol Hepatol. 2019 Apr;34(4):799-805. doi: 10.1111\/jgh.14528. Epub 2018 Nov 21. PMID: 30378169.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">de Oliveira PVAG, de Moura DTH, Ribeiro IB, Bazarbashi AN, Franzini TAP, Dos Santos MEL, Bernardo WM, de Moura EGH. Efficacy of digital single-operator cholangioscopy in the visual interpretation of indeterminate biliary strictures: a systematic review and meta-analysis. Surg Endosc. 2020 Aug;34(8):3321-3329. doi: 10.1007\/s00464-020-07583-8. Epub 2020 Apr 27. PMID: 32342216.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Liu Y, Lu Y, Sun B, Zhang WM, Zhang ZZ, He YP, Yang XJ. Probe-based confocal laser endomicroscopy for the diagnosis of undetermined biliary stenoses: A meta-analysis. Clin Res Hepatol Gastroenterol. 2016 Dec;40(6):666-673. doi: 10.1016\/j.clinre.2016.05.007. Epub 2016 Jun 24. PMID: 27350572.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Dumonceau JM, Tringali A, Papanikolaou IS, et al. Endoscopic biliary stenting: indications, choice of stents, and results: European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline &#8211; Updated October 2017. Endoscopy. 2018 Sep;50(9):910-930. doi: 10.1055\/a-0659-9864. Epub 2018 Aug 7. PMID: 30086596.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Fernandez Y Viesca M, Arvanitakis M. Early Diagnosis And Management Of Malignant Distal Biliary Obstruction: A Review On Current Recommendations And Guidelines. Clin Exp Gastroenterol. 2019 Nov 5;12:415-432. doi: 10.2147\/CEG.S195714. PMID: 31807048; PMCID: PMC6842280.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Sofi AA, Khan MA, Das A, et al. Radiofrequency ablation combined with biliary stent placement versus stent placement alone for malignant biliary strictures: a systematic review and meta-analysis. Gastrointest Endosc. 2018 Apr;87(4):944-951.e1. doi: 10.1016\/j.gie.2017.10.029. Epub 2017 Nov 3. PMID: 29108980<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\">Logiudice FP, Bernardo WM, Galetti F, et al. Endoscopic ultrasound-guided <i>vs<\/i> endoscopic retrograde cholangiopancreatography biliary drainage for obstructed distal malignant biliary strictures: A systematic review and meta-analysis. World J Gastrointest Endosc. 2019 Apr 16;11(4):281-291. doi: 10.4253\/wjge.v11.i4.281. PMID: 31040889; PMCID: PMC6475700.<\/li>\n<\/ol>\n<p><span style=\"font-weight: 400;\">Acesse o <\/span><a href=\"https:\/\/endoscopiaterapeutica.net\/pt\/\"><span style=\"font-weight: 400;\">Endoscopia Terap\u00eautica<\/span><\/a><span style=\"font-weight: 400;\"> para tomar contato com mais <\/span><a href=\"https:\/\/endoscopiaterapeutica.net\/pt\/artigos-comentados\/\"><span style=\"font-weight: 400;\">artigos comentados<\/span><\/a><span style=\"font-weight: 400;\">, <\/span><a href=\"https:\/\/endoscopiaterapeutica.net\/pt\/assuntos-gerais\/\"><span style=\"font-weight: 400;\">assuntos gerais<\/span><\/a><span style=\"font-weight: 400;\">, <\/span><a href=\"https:\/\/endoscopiaterapeutica.net\/pt\/casos-clinicos\/\"><span style=\"font-weight: 400;\">casos cl\u00ednicos<\/span><\/a><span style=\"font-weight: 400;\">, <\/span><a href=\"https:\/\/endoscopiaterapeutica.net\/pt\/quizes\/\"><span style=\"font-weight: 400;\">quizzes<\/span><\/a><span style=\"font-weight: 400;\">, <\/span><a href=\"https:\/\/endoscopiaterapeutica.net\/pt\/classificacoes\/\"><span style=\"font-weight: 400;\">classifica\u00e7\u00f5es<\/span><\/a><span style=\"font-weight: 400;\"> e mais!<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Pacientes com doen\u00e7a de Crohn (DC) e retocolite ulcerativa (RCU) apresentam uma baixa correla\u00e7\u00e3o entre a apresenta\u00e7\u00e3o de sintomas e a atividade inflamat\u00f3ria de doen\u00e7a. Al\u00e9m do mais, sabe-se que a adequada cicatriza\u00e7\u00e3o mucosa tem se associado com respostas cl\u00ednicas sustentadas, redu\u00e7\u00e3o de uso de corticosteroides, redu\u00e7\u00e3o de hospitaliza\u00e7\u00f5es e mesmo de cirurgias e c\u00e2ncer colorretal.<\/p>\n","protected":false},"author":2592,"featured_media":4924,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_lmt_disableupdate":"","_lmt_disable":"","footnotes":""},"categories":[151],"tags":[],"ano":[262],"tipo":[153],"volume":[263],"class_list":["post-4926","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-assuntosgerais","ano-262","tipo-endoscopia-digestiva-alta","volume-volume-i"],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v27.2 (Yoast SEO v27.4) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Endoscopia no colangiocarcinoma &#8226; Endoscopia Terapeutica<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/endoscopiaterapeutica.net\/pt\/assuntosgerais\/endoscopia-no-colangiocarcinoma\/\" \/>\n<meta property=\"og:locale\" content=\"pt_BR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Endoscopia no colangiocarcinoma\" \/>\n<meta property=\"og:description\" content=\"Pacientes com doen\u00e7a de Crohn (DC) e retocolite ulcerativa (RCU) apresentam uma baixa correla\u00e7\u00e3o entre a apresenta\u00e7\u00e3o de sintomas e a atividade inflamat\u00f3ria de doen\u00e7a. Al\u00e9m do mais, sabe-se que a adequada cicatriza\u00e7\u00e3o mucosa tem se associado com respostas cl\u00ednicas sustentadas, redu\u00e7\u00e3o de uso de corticosteroides, redu\u00e7\u00e3o de hospitaliza\u00e7\u00f5es e mesmo de cirurgias e c\u00e2ncer colorretal.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/endoscopiaterapeutica.net\/pt\/assuntosgerais\/endoscopia-no-colangiocarcinoma\/\" \/>\n<meta property=\"og:site_name\" content=\"Endoscopia Terapeutica\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/endoscopiaterapeutica\" \/>\n<meta property=\"article:published_time\" content=\"2021-05-28T09:00:53+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2021-09-16T13:55:45+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/endoscopiaterapeutica.net\/pt\/wp-content\/uploads\/2021\/08\/Figura7.jpg?v=1628202231\" \/>\n\t<meta property=\"og:image:width\" content=\"640\" \/>\n\t<meta property=\"og:image:height\" content=\"480\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"author\" content=\"Joel Fernandez de Oliveira\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Escrito por\" \/>\n\t<meta name=\"twitter:data1\" content=\"Joel Fernandez de Oliveira\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. tempo de leitura\" \/>\n\t<meta name=\"twitter:data2\" content=\"7 minutos\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/endoscopiaterapeutica.net\\\/pt\\\/assuntosgerais\\\/endoscopia-no-colangiocarcinoma\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/endoscopiaterapeutica.net\\\/pt\\\/assuntosgerais\\\/endoscopia-no-colangiocarcinoma\\\/\"},\"author\":{\"name\":\"Joel Fernandez de Oliveira\",\"@id\":\"https:\\\/\\\/endoscopiaterapeutica.net\\\/pt\\\/#\\\/schema\\\/person\\\/44154e75b8892daa6137c7c3e9f6acd0\"},\"headline\":\"Endoscopia no colangiocarcinoma\",\"datePublished\":\"2021-05-28T09:00:53+00:00\",\"dateModified\":\"2021-09-16T13:55:45+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/endoscopiaterapeutica.net\\\/pt\\\/assuntosgerais\\\/endoscopia-no-colangiocarcinoma\\\/\"},\"wordCount\":1430,\"commentCount\":0,\"publisher\":{\"@id\":\"https:\\\/\\\/endoscopiaterapeutica.net\\\/pt\\\/#organization\"},\"image\":{\"@id\":\"https:\\\/\\\/endoscopiaterapeutica.net\\\/pt\\\/assuntosgerais\\\/endoscopia-no-colangiocarcinoma\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/endoscopiaterapeutica.net\\\/pt\\\/wp-content\\\/uploads\\\/2021\\\/08\\\/Figura7.jpg?v=1628202231\",\"articleSection\":[\"Assuntos Gerais\"],\"inLanguage\":\"pt-BR\",\"potentialAction\":[{\"@type\":\"CommentAction\",\"name\":\"Comment\",\"target\":[\"https:\\\/\\\/endoscopiaterapeutica.net\\\/pt\\\/assuntosgerais\\\/endoscopia-no-colangiocarcinoma\\\/#respond\"]}]},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/endoscopiaterapeutica.net\\\/pt\\\/assuntosgerais\\\/endoscopia-no-colangiocarcinoma\\\/\",\"url\":\"https:\\\/\\\/endoscopiaterapeutica.net\\\/pt\\\/assuntosgerais\\\/endoscopia-no-colangiocarcinoma\\\/\",\"name\":\"Endoscopia no colangiocarcinoma &#8226; Endoscopia Terapeutica\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/endoscopiaterapeutica.net\\\/pt\\\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\\\/\\\/endoscopiaterapeutica.net\\\/pt\\\/assuntosgerais\\\/endoscopia-no-colangiocarcinoma\\\/#primaryimage\"},\"image\":{\"@id\":\"https:\\\/\\\/endoscopiaterapeutica.net\\\/pt\\\/assuntosgerais\\\/endoscopia-no-colangiocarcinoma\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/endoscopiaterapeutica.net\\\/pt\\\/wp-content\\\/uploads\\\/2021\\\/08\\\/Figura7.jpg?v=1628202231\",\"datePublished\":\"2021-05-28T09:00:53+00:00\",\"dateModified\":\"2021-09-16T13:55:45+00:00\",\"breadcrumb\":{\"@id\":\"https:\\\/\\\/endoscopiaterapeutica.net\\\/pt\\\/assuntosgerais\\\/endoscopia-no-colangiocarcinoma\\\/#breadcrumb\"},\"inLanguage\":\"pt-BR\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\\\/\\\/endoscopiaterapeutica.net\\\/pt\\\/assuntosgerais\\\/endoscopia-no-colangiocarcinoma\\\/\"]}]},{\"@type\":\"ImageObject\",\"inLanguage\":\"pt-BR\",\"@id\":\"https:\\\/\\\/endoscopiaterapeutica.net\\\/pt\\\/assuntosgerais\\\/endoscopia-no-colangiocarcinoma\\\/#primaryimage\",\"url\":\"https:\\\/\\\/endoscopiaterapeutica.net\\\/pt\\\/wp-content\\\/uploads\\\/2021\\\/08\\\/Figura7.jpg?v=1628202231\",\"contentUrl\":\"https:\\\/\\\/endoscopiaterapeutica.net\\\/pt\\\/wp-content\\\/uploads\\\/2021\\\/08\\\/Figura7.jpg?v=1628202231\",\"width\":640,\"height\":480},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\\\/\\\/endoscopiaterapeutica.net\\\/pt\\\/assuntosgerais\\\/endoscopia-no-colangiocarcinoma\\\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\\\/\\\/endoscopiaterapeutica.net\\\/pt\\\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Endoscopia no colangiocarcinoma\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\\\/\\\/endoscopiaterapeutica.net\\\/pt\\\/#website\",\"url\":\"https:\\\/\\\/endoscopiaterapeutica.net\\\/pt\\\/\",\"name\":\"Endoscopia Terapeutica\",\"description\":\"O Jornal Endoscopia Terap\u00eautica tem como objetivo compartilhar experi\u00eancias da pr\u00e1tica di\u00e1ria, al\u00e9m de prover atualiza\u00e7\u00f5es e discuss\u00f5es sobre endoscopia digestiva.\",\"publisher\":{\"@id\":\"https:\\\/\\\/endoscopiaterapeutica.net\\\/pt\\\/#organization\"},\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\\\/\\\/endoscopiaterapeutica.net\\\/pt\\\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"pt-BR\"},{\"@type\":\"Organization\",\"@id\":\"https:\\\/\\\/endoscopiaterapeutica.net\\\/pt\\\/#organization\",\"name\":\"Endoscopia Terapeutica\",\"url\":\"https:\\\/\\\/endoscopiaterapeutica.net\\\/pt\\\/\",\"logo\":{\"@type\":\"ImageObject\",\"inLanguage\":\"pt-BR\",\"@id\":\"https:\\\/\\\/endoscopiaterapeutica.net\\\/pt\\\/#\\\/schema\\\/logo\\\/image\\\/\",\"url\":\"https:\\\/\\\/endoscopiaterapeutica.net\\\/pt\\\/wp-content\\\/uploads\\\/2023\\\/09\\\/endter.jpg\",\"contentUrl\":\"https:\\\/\\\/endoscopiaterapeutica.net\\\/pt\\\/wp-content\\\/uploads\\\/2023\\\/09\\\/endter.jpg\",\"width\":720,\"height\":721,\"caption\":\"Endoscopia Terapeutica\"},\"image\":{\"@id\":\"https:\\\/\\\/endoscopiaterapeutica.net\\\/pt\\\/#\\\/schema\\\/logo\\\/image\\\/\"},\"sameAs\":[\"https:\\\/\\\/www.facebook.com\\\/endoscopiaterapeutica\",\"https:\\\/\\\/www.instagram.com\\\/endoscopy\\\/\",\"https:\\\/\\\/www.youtube.com\\\/@endoscopyonline\"]},{\"@type\":\"Person\",\"@id\":\"https:\\\/\\\/endoscopiaterapeutica.net\\\/pt\\\/#\\\/schema\\\/person\\\/44154e75b8892daa6137c7c3e9f6acd0\",\"name\":\"Joel Fernandez de Oliveira\",\"image\":{\"@type\":\"ImageObject\",\"inLanguage\":\"pt-BR\",\"@id\":\"https:\\\/\\\/endoscopiaterapeutica.net\\\/pt\\\/wp-content\\\/uploads\\\/2021\\\/07\\\/joel.jpg\",\"url\":\"https:\\\/\\\/endoscopiaterapeutica.net\\\/pt\\\/wp-content\\\/uploads\\\/2021\\\/07\\\/joel.jpg\",\"contentUrl\":\"https:\\\/\\\/endoscopiaterapeutica.net\\\/pt\\\/wp-content\\\/uploads\\\/2021\\\/07\\\/joel.jpg\",\"caption\":\"Joel Fernandez de Oliveira\"},\"description\":\"Endoscopista no Hospital Vila Nova Star, Hospital Nipo-Brasileiro, Hospital Alem\u00e3o Oswaldo Cruz, Alta Excel\u00eancia Diagn\u00f3stica e Cl\u00ednica do Aparelho Digestivo. Mestre em Gastroenterologia pela Faculdade de Medicina da Universidade de S\u00e3o Paulo. Especializa\u00e7\u00e3o em Endoscopia Oncol\u00f3gica no Instituto do C\u00e2ncer do Estado de S\u00e3o Paulo \u2013 ICESP. Resid\u00eancia m\u00e9dica em Endoscopia Gastrointestinal no Hospital das Cl\u00ednicas da Faculdade de Medicina da Universidade de S\u00e3o Paulo.\",\"url\":\"https:\\\/\\\/endoscopiaterapeutica.net\\\/pt\\\/author\\\/jfoliveira\\\/\"}]}<\/script>\n<!-- \/ Yoast SEO Premium plugin. -->","yoast_head_json":{"title":"Endoscopia no colangiocarcinoma &#8226; Endoscopia Terapeutica","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/endoscopiaterapeutica.net\/pt\/assuntosgerais\/endoscopia-no-colangiocarcinoma\/","og_locale":"pt_BR","og_type":"article","og_title":"Endoscopia no colangiocarcinoma","og_description":"Pacientes com doen\u00e7a de Crohn (DC) e retocolite ulcerativa (RCU) apresentam uma baixa correla\u00e7\u00e3o entre a apresenta\u00e7\u00e3o de sintomas e a atividade inflamat\u00f3ria de doen\u00e7a. Al\u00e9m do mais, sabe-se que a adequada cicatriza\u00e7\u00e3o mucosa tem se associado com respostas cl\u00ednicas sustentadas, redu\u00e7\u00e3o de uso de corticosteroides, redu\u00e7\u00e3o de hospitaliza\u00e7\u00f5es e mesmo de cirurgias e c\u00e2ncer colorretal.","og_url":"https:\/\/endoscopiaterapeutica.net\/pt\/assuntosgerais\/endoscopia-no-colangiocarcinoma\/","og_site_name":"Endoscopia Terapeutica","article_publisher":"https:\/\/www.facebook.com\/endoscopiaterapeutica","article_published_time":"2021-05-28T09:00:53+00:00","article_modified_time":"2021-09-16T13:55:45+00:00","og_image":[{"width":640,"height":480,"url":"https:\/\/endoscopiaterapeutica.net\/pt\/wp-content\/uploads\/2021\/08\/Figura7.jpg?v=1628202231","type":"image\/jpeg"}],"author":"Joel Fernandez de Oliveira","twitter_card":"summary_large_image","twitter_misc":{"Escrito por":"Joel Fernandez de Oliveira","Est. tempo de leitura":"7 minutos"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"Article","@id":"https:\/\/endoscopiaterapeutica.net\/pt\/assuntosgerais\/endoscopia-no-colangiocarcinoma\/#article","isPartOf":{"@id":"https:\/\/endoscopiaterapeutica.net\/pt\/assuntosgerais\/endoscopia-no-colangiocarcinoma\/"},"author":{"name":"Joel Fernandez de Oliveira","@id":"https:\/\/endoscopiaterapeutica.net\/pt\/#\/schema\/person\/44154e75b8892daa6137c7c3e9f6acd0"},"headline":"Endoscopia no colangiocarcinoma","datePublished":"2021-05-28T09:00:53+00:00","dateModified":"2021-09-16T13:55:45+00:00","mainEntityOfPage":{"@id":"https:\/\/endoscopiaterapeutica.net\/pt\/assuntosgerais\/endoscopia-no-colangiocarcinoma\/"},"wordCount":1430,"commentCount":0,"publisher":{"@id":"https:\/\/endoscopiaterapeutica.net\/pt\/#organization"},"image":{"@id":"https:\/\/endoscopiaterapeutica.net\/pt\/assuntosgerais\/endoscopia-no-colangiocarcinoma\/#primaryimage"},"thumbnailUrl":"https:\/\/endoscopiaterapeutica.net\/pt\/wp-content\/uploads\/2021\/08\/Figura7.jpg?v=1628202231","articleSection":["Assuntos Gerais"],"inLanguage":"pt-BR","potentialAction":[{"@type":"CommentAction","name":"Comment","target":["https:\/\/endoscopiaterapeutica.net\/pt\/assuntosgerais\/endoscopia-no-colangiocarcinoma\/#respond"]}]},{"@type":"WebPage","@id":"https:\/\/endoscopiaterapeutica.net\/pt\/assuntosgerais\/endoscopia-no-colangiocarcinoma\/","url":"https:\/\/endoscopiaterapeutica.net\/pt\/assuntosgerais\/endoscopia-no-colangiocarcinoma\/","name":"Endoscopia no colangiocarcinoma &#8226; Endoscopia Terapeutica","isPartOf":{"@id":"https:\/\/endoscopiaterapeutica.net\/pt\/#website"},"primaryImageOfPage":{"@id":"https:\/\/endoscopiaterapeutica.net\/pt\/assuntosgerais\/endoscopia-no-colangiocarcinoma\/#primaryimage"},"image":{"@id":"https:\/\/endoscopiaterapeutica.net\/pt\/assuntosgerais\/endoscopia-no-colangiocarcinoma\/#primaryimage"},"thumbnailUrl":"https:\/\/endoscopiaterapeutica.net\/pt\/wp-content\/uploads\/2021\/08\/Figura7.jpg?v=1628202231","datePublished":"2021-05-28T09:00:53+00:00","dateModified":"2021-09-16T13:55:45+00:00","breadcrumb":{"@id":"https:\/\/endoscopiaterapeutica.net\/pt\/assuntosgerais\/endoscopia-no-colangiocarcinoma\/#breadcrumb"},"inLanguage":"pt-BR","potentialAction":[{"@type":"ReadAction","target":["https:\/\/endoscopiaterapeutica.net\/pt\/assuntosgerais\/endoscopia-no-colangiocarcinoma\/"]}]},{"@type":"ImageObject","inLanguage":"pt-BR","@id":"https:\/\/endoscopiaterapeutica.net\/pt\/assuntosgerais\/endoscopia-no-colangiocarcinoma\/#primaryimage","url":"https:\/\/endoscopiaterapeutica.net\/pt\/wp-content\/uploads\/2021\/08\/Figura7.jpg?v=1628202231","contentUrl":"https:\/\/endoscopiaterapeutica.net\/pt\/wp-content\/uploads\/2021\/08\/Figura7.jpg?v=1628202231","width":640,"height":480},{"@type":"BreadcrumbList","@id":"https:\/\/endoscopiaterapeutica.net\/pt\/assuntosgerais\/endoscopia-no-colangiocarcinoma\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/endoscopiaterapeutica.net\/pt\/"},{"@type":"ListItem","position":2,"name":"Endoscopia no colangiocarcinoma"}]},{"@type":"WebSite","@id":"https:\/\/endoscopiaterapeutica.net\/pt\/#website","url":"https:\/\/endoscopiaterapeutica.net\/pt\/","name":"Endoscopia Terapeutica","description":"O Jornal Endoscopia Terap\u00eautica tem como objetivo compartilhar experi\u00eancias da pr\u00e1tica di\u00e1ria, al\u00e9m de prover atualiza\u00e7\u00f5es e discuss\u00f5es sobre endoscopia digestiva.","publisher":{"@id":"https:\/\/endoscopiaterapeutica.net\/pt\/#organization"},"potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/endoscopiaterapeutica.net\/pt\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"pt-BR"},{"@type":"Organization","@id":"https:\/\/endoscopiaterapeutica.net\/pt\/#organization","name":"Endoscopia Terapeutica","url":"https:\/\/endoscopiaterapeutica.net\/pt\/","logo":{"@type":"ImageObject","inLanguage":"pt-BR","@id":"https:\/\/endoscopiaterapeutica.net\/pt\/#\/schema\/logo\/image\/","url":"https:\/\/endoscopiaterapeutica.net\/pt\/wp-content\/uploads\/2023\/09\/endter.jpg","contentUrl":"https:\/\/endoscopiaterapeutica.net\/pt\/wp-content\/uploads\/2023\/09\/endter.jpg","width":720,"height":721,"caption":"Endoscopia Terapeutica"},"image":{"@id":"https:\/\/endoscopiaterapeutica.net\/pt\/#\/schema\/logo\/image\/"},"sameAs":["https:\/\/www.facebook.com\/endoscopiaterapeutica","https:\/\/www.instagram.com\/endoscopy\/","https:\/\/www.youtube.com\/@endoscopyonline"]},{"@type":"Person","@id":"https:\/\/endoscopiaterapeutica.net\/pt\/#\/schema\/person\/44154e75b8892daa6137c7c3e9f6acd0","name":"Joel Fernandez de Oliveira","image":{"@type":"ImageObject","inLanguage":"pt-BR","@id":"https:\/\/endoscopiaterapeutica.net\/pt\/wp-content\/uploads\/2021\/07\/joel.jpg","url":"https:\/\/endoscopiaterapeutica.net\/pt\/wp-content\/uploads\/2021\/07\/joel.jpg","contentUrl":"https:\/\/endoscopiaterapeutica.net\/pt\/wp-content\/uploads\/2021\/07\/joel.jpg","caption":"Joel Fernandez de Oliveira"},"description":"Endoscopista no Hospital Vila Nova Star, Hospital Nipo-Brasileiro, Hospital Alem\u00e3o Oswaldo Cruz, Alta Excel\u00eancia Diagn\u00f3stica e Cl\u00ednica do Aparelho Digestivo. Mestre em Gastroenterologia pela Faculdade de Medicina da Universidade de S\u00e3o Paulo. Especializa\u00e7\u00e3o em Endoscopia Oncol\u00f3gica no Instituto do C\u00e2ncer do Estado de S\u00e3o Paulo \u2013 ICESP. Resid\u00eancia m\u00e9dica em Endoscopia Gastrointestinal no Hospital das Cl\u00ednicas da Faculdade de Medicina da Universidade de S\u00e3o Paulo.","url":"https:\/\/endoscopiaterapeutica.net\/pt\/author\/jfoliveira\/"}]}},"_links":{"self":[{"href":"https:\/\/endoscopiaterapeutica.net\/pt\/wp-json\/wp\/v2\/posts\/4926","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/endoscopiaterapeutica.net\/pt\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/endoscopiaterapeutica.net\/pt\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/endoscopiaterapeutica.net\/pt\/wp-json\/wp\/v2\/users\/2592"}],"replies":[{"embeddable":true,"href":"https:\/\/endoscopiaterapeutica.net\/pt\/wp-json\/wp\/v2\/comments?post=4926"}],"version-history":[{"count":1,"href":"https:\/\/endoscopiaterapeutica.net\/pt\/wp-json\/wp\/v2\/posts\/4926\/revisions"}],"predecessor-version":[{"id":5439,"href":"https:\/\/endoscopiaterapeutica.net\/pt\/wp-json\/wp\/v2\/posts\/4926\/revisions\/5439"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/endoscopiaterapeutica.net\/pt\/wp-json\/wp\/v2\/media\/4924"}],"wp:attachment":[{"href":"https:\/\/endoscopiaterapeutica.net\/pt\/wp-json\/wp\/v2\/media?parent=4926"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/endoscopiaterapeutica.net\/pt\/wp-json\/wp\/v2\/categories?post=4926"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/endoscopiaterapeutica.net\/pt\/wp-json\/wp\/v2\/tags?post=4926"},{"taxonomy":"ano","embeddable":true,"href":"https:\/\/endoscopiaterapeutica.net\/pt\/wp-json\/wp\/v2\/ano?post=4926"},{"taxonomy":"tipo","embeddable":true,"href":"https:\/\/endoscopiaterapeutica.net\/pt\/wp-json\/wp\/v2\/tipo?post=4926"},{"taxonomy":"volume","embeddable":true,"href":"https:\/\/endoscopiaterapeutica.net\/pt\/wp-json\/wp\/v2\/volume?post=4926"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}