Biliary Tree Diagnostics: Advances in Endoscopic Imaging and Tissue Sampling

Ghisa, Matteo; Bellumat, Angelo; Bona, Manuela De; Valiante, F.; Tollardo, M.; Iacobellis, A.; Savarino, Edoardo; Buda, Andrea

doi:10.3390/medicina58010135

Cited by 5 publications

(4 citation statements)

References 107 publications

(122 reference statements)

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“…All of these are designed to offer greater resolution, higher image clarity and a virtual biopsy to increase the sensitivity of the actual final pathological specimen obtained. 21 This report highlights the importance of definitive diagnosis using cholangioscopy with biopsy, in cases where the pretest probability of malignancy may be high, thus, preventing the unnecessary morbidity of major abdominal surgery.…”

Section: Discussionmentioning

confidence: 76%

The Use of Cholangioscopy In the Diagnosis of Indeterminate Biliary Strictures: A Case Report and Review of the Literature

Sudan,

Costable,

Medina Rojas

et al. 2023

Journal of Brown Hospital Medicine

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Biliary strictures or narrowing of a portion of the biliary tree can have benign and malignant etiologies. One third of these will originate from iatrogenic injury and these are typically managed endoscopically. We present the case of a 76-year-old man with history of laparoscopic cholecystectomy ten years prior, who presented with one week of jaundice, dark urine, and pruritus. Along with non-invasive biliary imaging, he underwent cholangioscopy during endoscopic retrograde cholangiopancreatography revealing inflammatory-appearing stenosis of the common hepatic duct with embedded suture material. The stenotic area was biopsied using mini forceps and subsequently dilated with a balloon dilator. A plastic biliary stent was placed with improvement in the patient’s hepatic function, with final cytology and pathology being negative for malignancy. Cholangioscopy facilitated detailed visual inspection of strictures and biopsies under direct visualization. The visual impression increased the sensitivity of the biopsy and assisted in ruling out malignancy from the most critical portion of the stricture. While timing of cholangioscopy remains to be determined, its use is a valuable tool in the diagnosis of indeterminate biliary strictures.

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Section: Discussionmentioning

confidence: 76%

The Use of Cholangioscopy In the Diagnosis of Indeterminate Biliary Strictures: A Case Report and Review of the Literature

Sudan,

Costable,

Medina Rojas

et al. 2023

Journal of Brown Hospital Medicine

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“…To properly treat and diagnose biliary strictures, visualization of the target area is needed, and biopsies must be taken 3 , 4 . Conventional methods have poor accuracy in distinguishing between benign and malignant etiologies, and diagnosing these patients presents a challenge 1 , 4 , 5 .…”

Section: Introductionmentioning

confidence: 99%

Cholangioscopy with Spyglass DS using percutaneous transhepatic cholangiography access: a retrospective cohort study

Ulvund Solstad,

Thorsteinsson,

Schultz

et al. 2024

Annals of Medicine &Amp; Surgery

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Background: Conventional peroral methods to visualize biliary strictures are not feasible in some patients with altered anatomy or biliary obstruction, and percutaneous transhepatic cholangioscopy can be used as an alternative procedure. This study aimed to retrospectively review the use of percutaneous transhepatic cholangiography using the SpyGlass DS technology (S-PTCS) during a 5-year period at a Danish tertiary referral center. Materials and Methods: All patients who underwent S-PTCS at a single Danish tertiary referral center between 2016 and 2021 were retrospectively analyzed. The visual, technical, and overall success rates of S-PTCS were analyzed, as well as the complication rate. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of S-PTCS were calculated. Results: Twenty-two patients were included in the study. Visual, technical, and overall success of S-PTCS was achieved in 17/22, 22/22, and 21/22 patients, respectively. S-PTCS yielded a sensitivity of 83.3%, a specificity of 100%, a PPV of 100%, a NPV of 94.1%, and an accuracy of 95.4%. Complications occurred in 1/22 patients. Conclusion: S-PTCS is a safe modality, with high success rates, high predictive values, and a low rate of complications. This study suggests that S-PTCS is an alternative to conventional methods in patients with indeterminate biliary strictures where conventional methods were unfeasible.

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“…10 ). The diagnosis of pathological changes in this region is further very difficult, due in particular to poor availability [11][12][13] .…”

Section: Introductionmentioning

confidence: 99%

The contribution of new methods in cytology for increasing sensitivity in the diagnosis of extrahepatic bile duct lesions

Kurfurstova,

Slobodova,

Zoundjiekpon

et al. 2023

BIOMED PAP

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The aim of this review is to provide a comprehensive analysis of the existing literature pertaining to cytology of extrahepatic bile ducts. A search using the keywords "biliary brush cytology" was conducted in the PubMed database, with a focus on recent articles. The inclusion criteria primarily encompassed publications addressing problematic biliary stenosis. Emphasis was placed on identifying articles that explored innovative or less-utilized examination techniques aimed at enhancing the sensitivity of cytological examination. This review presents a comprehensive overview of the various types of materials used in sampling and the corresponding sampling methods. Additionally, it explores cytological and cytogenetic techniques, such as fluorescence in situ hybridization (FISH) and genetic methods (miRNA, NGS, cfDNA). These techniques possess the potential to improve the accuracy of diagnosing bile duct tumors, although their sensitivity varies. Furthermore, their utilization can facilitate early therapy, which plays a crucial role in patient prognosis. Each examination is always dependent on the quality and quantity of material delivered. A higher sensitivity of these examinations can be achieved by combining biliary cytology and other complementary methods.

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Biliary Tree Diagnostics: Advances in Endoscopic Imaging and Tissue Sampling

Cited by 5 publications

References 107 publications

The Use of Cholangioscopy In the Diagnosis of Indeterminate Biliary Strictures: A Case Report and Review of the Literature

The Use of Cholangioscopy In the Diagnosis of Indeterminate Biliary Strictures: A Case Report and Review of the Literature

Cholangioscopy with Spyglass DS using percutaneous transhepatic cholangiography access: a retrospective cohort study

The contribution of new methods in cytology for increasing sensitivity in the diagnosis of extrahepatic bile duct lesions

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