Endoscopic needle aspiration biopsy at ERCP in the diagnosis of biliary strictures

Utility of EUS in patients with indeterminate biliary strictures and suspected extrahepatic cholangiocarcinoma (with videos)

“…[22][23][24][25][26][27][28][29] Multiple strategies have been used to improve the sensitivity, with marginal benefit. These have included novel brushing devices, 30 biliary stricture dilation with subsequent brushings, 31 repeated brushings, 31 endoscopic needle aspiration, 26 immunohistochemistry testing, 32 and mutational analysis. 32 Inadequate biliary cytology specimens remains the main reason for nondiagnostic samples during ERCP.…”

Fluorescence in situ hybridization in diagnostic cytology

“…The sensitivity of routine cytology (RC) obtained from endoscopic brushings ranges from 8% to 66% for brushing specimens and 6% to 50% for bile aspirate specimens [33][34][35]. Because RC has relatively poor sensitivity, one study [36] explored the use of FISH for the detection of biliary tract malignancy using the UroVysion probe set.…”

Role of EUS for preoperative evaluation of cholangiocarcinoma: a large single-center experience

“…4,5 Brush cytology during ERCP has been used for the diagnosis of CCA but with variable sensitivity, ranging from 33% to 80%. [6][7][8][9][10][11][12][13] The incorporation of new tissue acquisition techniques, such as endoscopic needle aspiration 7 and endobiliary forceps, [8][9][10][11] increases the sensitivity of tissue sampling of biliary strictures compared with brush cytology alone. The addition of peroral cholangioscopy has been reported to identify extrahepatic CCA with 100% sensitivity.…”