Team approach to ERCP-directed single-brush cytology for the diagnosis of malignancy

Abstract

Brush cytology is the most commonly used method when pathologic confirmation of pancreaticobiliary malignancy is required during endoscopic retrograde cholangiopancreatography (ERCP) (1-6). Intraductal

Combined brush cytology and stent placement in a single session for presumed malignant biliary stricture

“…In the present study, the sensitivity of brush cytology for presumed malignant biliary stricture was 83%, which was higher than those of previous English language published reports 1–7 . There are several factors that might contribute to this excellent sensitivity.…”

“…First, all materials were immediately stained by the attending cytologist for the provisional diagnosis and a second brushing was performed whenever required. A recent report also pointed out the importance of cooperation with attending cytologists 3 . It seems that attending cytologists are necessary to improve the sensitivity of brush cytology.…”

“…In the present study, the sensitivity of brush cytology for presumed malignant biliary stricture was 83%, which was higher than those of previous English language published reports. [1][2][3][4][5][6][7] There are several factors that might contribute to this excellent sensitivity. First, all materials were immediately stained by the attending cytologist for the provisional diagnosis and a second brushing was performed whenever required.…”

“…A recent report also pointed out the importance of cooperation with attending cytologists. 3 It seems that attending cytologists are necessary to improve the sensitivity of brush cytology. For the hospitals where attending cytologists are not available, we recommend performing several brushings routinely.…”

“…Brush cytology during endoscopic retrograde cholangiopancreatography (ERCP) is a simple and common technique for establishing the diagnosis of biliary stricture; however, its sensitivity has been reported to be low, ranging from 35% to 72%. [1][2][3][4][5][6][7] Alternative techniques, such as stricture dilation followed by collecting materials using grasping basket or a combination of several techniques including brush cytology, have been reported with improved sensitivity. [8][9][10][11] However, these procedures are more complicated and traumatic.…”