Complete tissue sampling of biliary strictures at ERCP using a new device

Howell, Douglas A.; Parsons, Willis G.; Jones, Michael A.; Bosco, John J.; Hanson, Brian L.

doi:10.1016/s0016-5107(96)70294-8

Cited by 100 publications

(50 citation statements)

References 7 publications

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“…[1][2][3][4][5][6][7][8][9][10][11][12] Transpapillary bile duct biopsy during endoscopic retrograde cholangiopancreatography (ERCP) is a simple, safe, and effective way to biopsy these strictures. [1][2][3][4][5][6][7] However, when biopsy fails to demonstrate malignancy, there are no clear guidelines for further management of these patients. In this study, we evaluated the role of intraductal ultrasonography (IDUS) in an effort to clarify these strictures when ERCP biopsy is negative.…”

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confidence: 99%

Endoscopic transpapillary bile duct biopsy with the combination of intraductal ultrasonography in the diagnosis of biliary strictures

Tamada

Tomiyama

Wada

et al. 2002

Gut

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Background: When endoscopic retrograde cholangiopancreatography (ERCP) guided bile duct biopsy fails to demonstrate malignancy, it remains unclear how to manage patients with presumably malignant strictures. Aims: To evaluate the value of intraductal ultrasonography (IDUS) when bile duct biopsy is negative. Methods: Sixty two patients with strictures of the bile duct were studied prospectively. During ERCP, IDUS was performed using an ultrasonic probe (diameter 2.0 mm; frequency 20 MHz). Following IDUS, a bile duct biopsy was performed using forceps (diameter 1.8 mm). The IDUS images of the tumour were classified as polypoid lesions, localised wall thickening, intraductal sessile tumours, sessile tumour outside of the bile duct, or absence of apparent lesion. The bile duct wall structures at the site of the tumour as well as the maximum diameter of the tumour were also analysed. The IDUS findings were compared with the histological findings or clinical course. Results: When the IDUS images showed a polypoid lesion (n=19), localised wall thickening (n=8), intraductal sessile tumour (n=13), and sessile tumour outside of the bile duct (n = 20), the sensitivities of the biopsy were 80%, 50%, 92%, and 53%, respectively. Multiple regression analysis showed that the presence of sessile tumour (intraductal or outside of the bile duct: p<0.05), tumour size greater than 10.0 mm (p<0.001), and interrupted wall structure (p<0.05) were independent variables that predicted malignancy. Conclusion:When biopsy fails to demonstrate evidence of malignancy, the presence of sessile tumour (intraductal or outside of the bile duct), tumour size greater than 10.0 mm, and interrupted wall structure on IDUS images are factors that can predict malignancy.

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confidence: 99%

Endoscopic transpapillary bile duct biopsy with the combination of intraductal ultrasonography in the diagnosis of biliary strictures

Tamada

Tomiyama

Wada

et al. 2002

Gut

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“…Another endoscopic approach is to take biopsies of the stricture using routine or modified biopsy forceps. This can be technically demanding but, when biopsies are obtained, confirmation of cancer has been reported in approximately 50% of cases (Howell et al, 1996). Currently, the procedure with the highest sensitivity for cancer is cytologic evaluation of fine-needle aspirates taken during endoscopic ultrasound (Figure 3f).…”

Section: Tissue Samplingmentioning

confidence: 99%

Diagnostic and Therapeutic Endoscopy in the Biliary Tract and Pancreas

Roberts‐Thomson¹,

Nguyen²

2011

Therapeutic Gastrointestinal Endoscopy

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“…Traditionally, ERCP may be of assistance in characterizing the stricture by providing tissue sampling; however, the low yield rates of ERCPbased methods for securing the pathologic diagnosis of malignancy has been demonstrated in multiple studies. The diagnostic yield is variable in the range of 35% to 70% [31][32][33][34][35][36][37][38][39][40][41][42][43] . Percutaneous transhepatic cholangioscopy (PTCS) and POCS have both been used to obtain visually guided biopsies.…”

Section: Diagnostic Applicationsmentioning

confidence: 99%

Intraductal biliary and pancreatic endoscopy: An expanding scope of possibility

Judah

Draganov²

2008

WJG

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Intraductal endoscopy describes the use of an endoscope to directly visualize the biliary and pancreatic ducts. For many years, technological challenges have made performing these procedures difficult. The "mother-baby" system and other various miniscopes have been developed, but routine use has been hampered due to complex setup, scope fragility and the time consuming, technically demanding nature of the procedure. Recently, the SpyGlass peroral cholangiopancreatoscopy system has shown early success at providing diagnostic information and therapeutic options. The clinical utility of intraductal endoscopy is broad. It allows better differentiation between benign and malignant processes by allowing direct visualization and targeted sampling of tissue. Therapeutic interventions, such as electrohydraulic lithotripsy (EHL), laser lithotripsy, photodynamic therapy, and argon plasma coagulation (APC), may also be performed as part of intraductal endoscopy. I n t ra d u c t a l e n d o s c o p y s i g n i f i c a n t l y i n c r e a s e s the diagnostic and therapeutic yield of standard endoscopic retrograde cholangiography (ERCP), and as technology progresses, it is likely that its utilization will only increase. In this review of intraductal endoscopy, we describe in detail the various endoscopic platforms and their diagnostic and clinical applications.

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Complete tissue sampling of biliary strictures at ERCP using a new device

Cited by 100 publications

References 7 publications

Endoscopic transpapillary bile duct biopsy with the combination of intraductal ultrasonography in the diagnosis of biliary strictures

Endoscopic transpapillary bile duct biopsy with the combination of intraductal ultrasonography in the diagnosis of biliary strictures

Diagnostic and Therapeutic Endoscopy in the Biliary Tract and Pancreas

Intraductal biliary and pancreatic endoscopy: An expanding scope of possibility

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