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In the recent decade, wire-guided intraductal US(IDUS), which can be passed through the working channel of standard duodenoscopes to provide high-frequency ultrasound images, has been developed as a newly diagnostic tool for biliary and pancreatic duct lesions.In conclusion, IDUS alone or the combination ofIDUS and other modalities may be helpful for not onlydifferentiation between benign and malignant lesions,but also accurate diagnosis of cancer extension inpatients with pancreatobiliary diseases.