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GIE Volume 3, No. 1 : 2018 ERCP. Probe-based confocal laser endomicroscopy (pCLE) is a safe, innovative endoscopic method, which offers the potential of real-time in vivo diagnosis. High sensitivity, negative predictive value, and diagnostic accuracy (>95%) have been demonstrated by the use of pCLE according to the Miami and Paris classifications for biliary strictures. A 62-year-old woman presented with abdominal pain, vomiting, and jaundice. After the diagnosis of cholecystitis and cholelithiasis, she underwent cholecystectomy and ERCP in another hospital. After 3 months, she presented with recurrent jaundice and weight loss of 23 kg (about 30% of body weight) without signs of cholangitis. An abdominal CT scan identified a solid mass at the hilum (Fig. 1). Owing to infiltration of the hepatic artery, surgical resection was contraindicated. The patient underwent ERCP for biliary drainage in addition to pCLE evaluation of the hilar stricture with the use of CholangioFlex (Mauna Kea Technologies, Paris, France). The resulting images showed characteristics of malignant stenosis with thick bands, and increased dark cells (Fig. 2). Biopsy specimens were obtained, and brush cytology was performed to confirm the diagnosis, followed by the insertion of plastic stents. After histologic confirmation of cholangiocarcinoma, the patient underwent another