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Endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic ultrasonography (EUS) are key diagnostic modalities for IgG4\u2010SC. Cholangiocarcinoma and primary sclerosing cholangitis (PSC) are significant mimickers of IgG4\u2010SC. ERCP is employed to evaluate narrowing of the bile duct, with cholangiograms of IgG4\u2010SC classified into four types. This cholangiographic classification is crucial for differential diagnosis. Characteristic cholangiographic findings of IgG4\u2010SC include diffuse or segmental strictures of the intrahepatic or extrahepatic bile ducts and intrahepatic strictures associated with autoimmune pancreatitis. ERCP is particularly useful for differentiating IgG4\u2010SC from PSC because their cholangiographic features differ. EUS and intraductal ultrasonography (IDUS) are used to assess thickening of the bile duct wall. Characteristic IDUS findings in IgG4\u2010SC include circular and symmetrical wall thickening, smooth outer and inner margins, and homogeneous internal echoes at stricture sites. Additionally, bile duct wall thickening at nonstricture sites is a typical IDUS feature of IgG4\u2010SC. Bile duct biopsy is used to evaluate pathological findings, although its diagnostic yield for IgG4\u2010SC is limited; its primary role is to exclude malignant biliary strictures. Duodenal papilla biopsy serves as a supplementary diagnostic tool for IgG4\u2010SC. EUS and\u00a0tissue acquisition also aid in diagnosing autoimmune pancreatitis as part of other organ involvement. Thus, endoscopic techniques play critical roles in the diagnosis of IgG4\u2010SC.<\/jats:p>","DOI":"10.1111\/den.15039","type":"journal-article","created":{"date-parts":[[2025,4,21]],"date-time":"2025-04-21T06:40:46Z","timestamp":1745217646000},"page":"824-833","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Endoscopic diagnosis of immunoglobulin G4\u2010related sclerosing cholangitis"],"prefix":"10.1111","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8342-886X","authenticated-orcid":false,"given":"Itaru","family":"Naitoh","sequence":"first","affiliation":[{"name":"Department of Gastroenterology Nagoya City University Midori Municipal Hospital  Aichi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michihiro","family":"Yoshida","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Nagoya City University Graduate School of Medical Sciences  Aichi 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