The ideal technique for processing SpyBite tissue specimens: a prospective, single-blinded, pilot-study of histology and cytology techniques

Baars, Jan; Keegan, Mathew; Bonnichsen, Mark; Aepli, Patrick; Theyventhiran, Ruben R.; Farrell, Elizabeth; Kench, James G.; Saxena, Payal; Kaffes, Arthur J.

doi:10.1055/a-0950-9554

Cited by 5 publications

(6 citation statements)

References 25 publications

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“…All SpyBite specimens obtained by SpyGlass cholangioscopy can be used for histopathological examination. In their study, the mean size of the specimens was 1.1 ± 0.74 mm, which was smaller than that in our study 13 . Our study indicates that adequate specimens can be obtained by elbow biopsy forceps and used for diagnosis.…”

Section: Discussioncontrasting

confidence: 84%

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Tissue sampling for biliary strictures using novel elbow biopsy forceps

Zhang

Huo

Guo

et al. 2021

Sci Rep

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We aim to evaluate the safety and feasibility of novel elbow biopsy forceps with a prebent head for sampling biliary strictures in our institution. A total of 24 patients (15 males and 9 females) with biliary stricture who underwent biliary biopsy during endoscopic retrograde cholangiopancreatography (ERCP) using novel elbow biopsy forceps from June 2019 to August 2020 were retrospectively included. The novel biopsy forceps had a head angulation of 30 degrees and were able to cannulate the bile duct and approach the biliary strictures easily to obtain adequate samples. The technical success rate, incidence of adverse events, and consistency of pathological and surgical specimens were assessed. This device was used successfully in all patients. A total of 52 biopsy specimens were obtained from 24 patients, and all specimens could be used for histopathological examination. Seventeen patients were diagnosed with malignancy based on biopsies, and all of them underwent surgical treatment. The histopathological findings of the biopsy specimens were in accordance with the postoperative pathology diagnoses. One of the seven patients was diagnosed with a benign lesion that was proven to be malignant during surgical treatment in the follow-up period. Two patients experienced a single episode of acute pancreatitis and recovered shortly after appropriate treatment. No patients experienced biliary perforation or biliary bleeding. Biopsy using novel elbow forceps in patients with biliary stenosis is feasible and safe. The novel device and related biopsy technique may be widely applied for biliary disease differentiation.

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Section: Discussioncontrasting

confidence: 84%

“…Follow-up results. The median follow-up time was 11 (7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20) months in patients with benign strictures.…”

Section: Pathological Diagnosis Via Biopsymentioning

confidence: 99%

Tissue sampling for biliary strictures using novel elbow biopsy forceps

Zhang

Huo

Guo

et al. 2021

Sci Rep

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“…Another method already used for processing smaller specimens is cell block cytology. A study by Baars et al [ 60 ] involving 240 SpyBite specimens from the upper gastrointestinal tract in 10 patients found that cellblock cytology results in fewer crush artifacts and requires a significantly smaller specimen to achieve equivalent diagnostic accuracy (1.49 mm vs 2.02 mm, P < 0.001) compared to standard histopathology. However, as this comparative analysis was performed using gastrointestinal samples, a pilot study involving six IBS patients was performed.…”

Section: Clinical Applicationsmentioning

confidence: 99%

“…However, as this comparative analysis was performed using gastrointestinal samples, a pilot study involving six IBS patients was performed. All 20 SpyBite samples were successfully processed by cell block cytology[ 60 ].…”

Section: Clinical Applicationsmentioning

confidence: 99%

Choledochoscopy: An update

Lee¹,

Teng²,

Shelat³

2021

WJGE

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Choledochoscopy, or cholangioscopy, is an endoscopic procedure for direct visualization within the biliary tract for diagnostic or therapeutic purposes. Since its conception in 1879, many variations and improvements are made to ensure relevance in diagnosing and managing a range of intrahepatic and extrahepatic biliary pathologies. This ranges from improved visual impression and optical guided biopsies of indeterminate biliary strictures and clinically indistinguishable pathologies to therapeutic uses in stone fragmentation and other ablative therapies. Furthermore, with the evolving understanding of biliary disorders, there are significant innovative ideas and techniques to fill this void, such as nuanced instances of biliary stenting and retrieving migrated ductal stents. With this in mind, we present a review of the current advancements in choledo-choscopy with new supporting evidence that further delineates the role of choledochoscopy in various diagnostic and therapeutic interventions, complications, limitations and put forth areas for further study.

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“…A recent study evaluated the use of cell block cytology, which is used for processing smaller specimens, versus standard histopathology of tissue obtained using SpyBite biopsy. Researchers found that there was no significant difference between the two techniques, and observed that cell block cytology tended to have less artifact secondary to crushing [21]. Another recent study evaluated the number of biopsies necessary to find a definitive diagnosis using SpyBite.…”

Section: Indeterminate Biliary Stricturesmentioning

confidence: 99%

The Expansion of Cholangioscopy: Established and Investigational Uses of SpyGlass in Biliary and Pancreatic Disorders

Yodice

Choma²,

Tadros

2020

Diagnostics

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Direct visualization of bile and pancreatic duct pathology is proving to be beneficial in patients where previous techniques have failed. Recent advancements in technology and the development of the SpyGlass system have led to an increased use of cholangioscopy. It is already known that SpyGlass is beneficial in patients with difficult bile duct stones and indeterminate biliary lesions through the use of targeted lithotripsy and visually guided biopsy. Cholangioscopy allows the visualization of hidden stone and guide wire placement across difficult strictures and selective cannulation of the intrahepatic and cystic ducts. It is also demonstrating its utility in investigational applications such as post-liver transplant and primary sclerosing cholangitis stricture treatment, evaluation of hemobilia, and guided radiofrequency ablation of ductal tumors. In addition to having clinical utility, cholangioscopy may also be cost-effective by limiting the number of repeat procedures. Cholangioscopy overall has similar complication rates compared to other standard endoscopic retrograde cholangioscopy (ERCP) techniques, but there may be higher rates of cholangitis. This could be mitigated with prophylactic antibiotic use, and overall, cholangioscopy has similar complication rates compared to other techniques.

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The ideal technique for processing SpyBite tissue specimens: a prospective, single-blinded, pilot-study of histology and cytology techniques

Cited by 5 publications

References 25 publications

Tissue sampling for biliary strictures using novel elbow biopsy forceps

Tissue sampling for biliary strictures using novel elbow biopsy forceps

Choledochoscopy: An update

The Expansion of Cholangioscopy: Established and Investigational Uses of SpyGlass in Biliary and Pancreatic Disorders

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