Background : Biliary TB (BTB) is a rare manifestation of Extrapulmonary TB but is seen relatively more commonly in the Philippines. Hence, it should always be a part of differential diagnoses for biliary strictures. To date, there is no established set of diagnostic guidelines for BTB. Our paper discusses 5 cases of successfully diagnosed Biliary TB in our institution. It also reviews the different available techniques to enhance diagnostic accuracy for BTB.

Methods : Using the hospital’s electronic chart, patients diagnosed with hepatobiliary TB from 2012 to 1st half of 2022 were determined and reviewed. The list was then shortlisted to include only those who have biliary ductal involvement.

Results : 5 BTB cases were determined, with 4 of them having obstructive jaundice. Four of them also presented with abdominal pain or discomfort. All had no previous history or symptoms of pulmonary TB. All of them underwent tissue sampling to rule out malignancy and confirm suspicion for BTB.

Conclusions : Definitive management of biliary stricture differ and is dependent on the etiology, hence the importance of making an accurate diagnosis. Different endoscopic methods, alone or in combination, with tissue sampling, must be done to enhance the accuracy of diagnosis. ERCP, EUS with biopsy, and cholangioscopy with or without the other novel imaging techniques, may be the best mode for ruling in BTB and ruling out other similarly presenting malignant, inflammatory, and auto-immune diseases.