Endoscopic ultrasound-guided fine needle aspiration biopsy of suspected cholangiocarcinoma

Eloubeidi, Mohamad A.; Chen, Victor K.; Jhala, Nirag; Eltoum, Isam; Jhala, Darshana; Chhieng, David C.; Syed, Sujath; Vickers, Selwyn M.; Wilcox, C. Mel

doi:10.1016/s1542-3565(04)00005-9

Cited by 272 publications

(146 citation statements)

References 31 publications

Supporting

Mentioning

134

Contrasting

Unclassified

Order By: Relevance

“…In another prospective study, EUS-guided FNA of suspected CC reported a diagnostic sensitivity of 86%, with a specificity of 100%. In the same study, EUSguided FNA had a positive impact on the treatment management of 84% of patients [139] .…”

Section: Endoscopic Ultrasound (Eus)mentioning

confidence: 73%

Advances in diagnosis, treatment and palliation of cholangiocarcinoma: 1990-2009

Aljiffry¹,

Walsh²,

Molinari³

2009

WJG

253

190

View full text Add to dashboard Cite

Several advances in diagnosis, treatment and palliation of cholangiocarcinoma (CC) have occurred in the last decades. A multidisciplinary approach to this disease is therefore recommended. CC is a relatively rare tumor and the main risk factors are: chronic inflammation, genetic predisposition and congenital abnormalities of the biliary tree. While the incidence of intra-hepatic CC is increasing, the incidence of extra-hepatic CC is trending down. The only curative treatment for CC is surgical resection with negative margins. Liver transplantation has been proposed only for selected patients with hilar CC that cannot be resected who have no metastatic disease after a period of neoadjuvant chemo-radiation therapy. Magnetic resonance imaging/ magnetic resonance cholangiopancreatography, positron emission tomography scan, endoscopic ultrasound and computed tomography scans are the most frequently used modalities for diagnosis and tumor staging. Adjuvant therapy, palliative chemotherapy and radiotherapy have been relatively ineffective for inoperable CC. For most of these patients biliary stenting provides effective palliation. Photodynamic therapy is an emerging palliative treatment that seems to provide pain relief, improve biliary patency and increase survival. The clinical utility of other emerging therapies such as transarterial chemoembolization, hepatic arterial chemoinfusion and high intensity intraductal ultrasound needs further study.

show abstract

Section: Endoscopic Ultrasound (Eus)mentioning

confidence: 73%

Advances in diagnosis, treatment and palliation of cholangiocarcinoma: 1990-2009

Aljiffry¹,

Walsh²,

Molinari³

2009

WJG

253

190

View full text Add to dashboard Cite

show abstract

“…However, only 12 reports have described EUS-FNA for biliary disease. Table 4 shows an overview of EUS-FNA for the biliary tract [Frischer-Ravens et al 2000Rösch et al 2004, Lee et al 2004Eloubeidi et al 2004;Byrne et al 2004;Meara et al 2006;DeWitt et al 2006;Mohamadnejad et al 2011;Ohshima et al 2011;Nayar et al 2011;Weilert et al 2014]. According to those reports, sensitivity and accuracy have been widely reported as 43-100% and 54-100%, respectively.…”

Section: Discussionmentioning

confidence: 99%

EUS-guided FNA for biliary disease as first-line modality to obtain histological evidence

Onda

Ogura

Kurisu

et al. 2016

Therap Adv Gastroenterol

View full text Add to dashboard Cite

Background: Few reports have described endoscopic ultrasound (EUS)-guided fine needle aspiration (FNA) for biliary lesions. In addition, adverse events were not completely examined in previous reports, due to the inclusion of cases in which biliary stents had already been placed. The present study aimed to investigate the diagnostic yield and adverse events of EUS-FNA for biliary lesions as the first-line diagnostic modality for consecutive prospectively registered patients. Methods: Inclusion criteria were as follows: (1) patients with suspected cholangiocarcinoma (CCA) based on computed tomography or other imaging modalities; (2) patients who had not previously undergone endoscopic retrograde cholangiopancreatography or EUS-FNA; (3) absence of surgically altered anatomy, such as Roux-en-Y anastomosis or duodenal obstruction caused by tumor invasion, through which an endoscope could not pass; and (4) provision of written informed consent to all procedures associated with the study. Results: A total of 47 consecutive patients with suspected CCA were registered to this study. Sensitivity and accuracy were 89% and 87%, respectively. On multivariate analysis, puncture site was the only factor associated with reduced diagnostic yield (hazard ration, 6.879; 95% confidence interval, 1.172–40.374; P = 0.033). Remarkably, no adverse events such as bleeding or bile leakage were associated with EUS-FNA in any of the 47 patients. Conclusions: Our results suggest that EUS-FNA can be safely performed for biliary disease without biliary stenting. Furthermore, this procedure may warrant use as the first-line diagnostic method, although our results need to be validated in future prospective studies.

show abstract

“…In one study, 20% of patients with cholangiocarcinoma missed by conventional cytology were identified by FISH without affecting the specificity [28] . Several studies have evaluated the diagnostic yield of endoscopic US fine needle aspiration in patients with biliary strictures [29][30][31][32] . In one of the studies, the sensitivity and specificity of biopsy were 89% and 100%, respectively [30] .…”

Section: Discussionmentioning

confidence: 99%

Differentiation of malignant and benign proximal bile duct strictures: The diagnostic dilemma

Kloek¹,

Delden²,

Erdogan³

et al. 2008

WJG

View full text Add to dashboard Cite

AIM:To identify the criteria for the differentiation of hilar cholangiocarcinoma (HCCA) from benign strictures. METHODS: A total of 68 patients underwent resection of lesions suspicious for HCCA between 1998 and 2006. The results of laboratory investigations, imaging studies and brush cytology were collected. These findings were analyzed to obtain the final diagnosis. RESULTS: Histological examination of the resected specimens confirmed HCCA in 58 patients (85%, group Ⅰ) whereas 10 patients (15%, group Ⅱ) were diagnosed to have benign strictures. The most common presenting symptom was obstructive jaundice in 77% patients (79% group Ⅰ vs 60% group Ⅱ, P = 0.23). Laboratory findings showed greater elevation of transaminase levels in group Ⅰ compared to group Ⅱ. The various imaging modalities showed vascular involvement exclusively in the malignant group (36%, P < 0.05). Brush cytology was positive for malignant cells in only 50% patients in group Ⅰ whereas none in group Ⅱ showed malignant cells. CONCLUSION: Despite improvements in imaging techniques, 10 patients (15%) with a presumptive diagnosis of HCCA were ultimately found to have benign strictures. Except for vascular involvement which was associated significantly with malignancy, there were no conclusive features of malignancy on regular imaging modalities. This uncertainty should be taken into account when patients with a suspicious lesion at the liver hilum are considered for resection.

show abstract

Endoscopic ultrasound-guided fine needle aspiration biopsy of suspected cholangiocarcinoma

Cited by 272 publications

References 31 publications

Advances in diagnosis, treatment and palliation of cholangiocarcinoma: 1990-2009

Advances in diagnosis, treatment and palliation of cholangiocarcinoma: 1990-2009

EUS-guided FNA for biliary disease as first-line modality to obtain histological evidence

Differentiation of malignant and benign proximal bile duct strictures: The diagnostic dilemma

Contact Info

Product

Resources

About