Usefulness of endoscopic retrograde biliary biopsy using large-capacity forceps for extrahepatic biliary strictures: a prospective randomized study

Ikeda, Miyuki; Maetani, Iruru; Terada, K.; Ukita, Takeo; Tada, Tomoko; Shigoka, Hiroaki; Omuta, Shigefumi; Takahashi, Ken

doi:10.1055/s-0030-1255633

Cited by 26 publications

(24 citation statements)

References 9 publications

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“…Efforts to improve the diagnostic yield of standard forceps biopsy have also been reported in the literature. In a prospective randomised study of 32 patients with biliary strictures (93.8% malignant), using a biopsy forceps with larger cup (2.2 mm in diameter) achieved a larger size of specimen (1.98 mm 2 vs 0.68 mm 2 , P < 0.0001) and a higher diagnostic sensitivity for all biliary strictures (70% vs 43%) and for bile duct cancer (92% vs 52%) than using standard biopsy forceps …”

Section: Resultsmentioning

confidence: 99%

Review article: Asia‐Pacific consensus recommendations on endoscopic tissue acquisition for biliary strictures

Sun¹,

Lee

Cai

et al. 2018

Aliment Pharmacol Ther

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Section: Resultsmentioning

confidence: 99%

Review article: Asia‐Pacific consensus recommendations on endoscopic tissue acquisition for biliary strictures

Sun¹,

Lee

Cai

et al. 2018

Aliment Pharmacol Ther

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“…Tamada et al report that a new ropeway-type biopsy forceps is useful for selectively obtaining biopsy specimens of the bile duct [ 20 ]. Large-capacity forceps have better adequacy of the sample, submucosal sampling, and cancer detection rate than the standard forceps [ 21 , 22 ]. Forceps biopsy with a combination of intraductal ultrasonography (IDUS) compensates for the false-negative rate [ 6 ].…”

Section: Discussionmentioning

confidence: 99%

Transpapillary biliary biopsy for malignant biliary strictures: comparison between cholangiocarcinoma and pancreatic cancer

et al. 2016

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BackgroundTissue sampling for biliary stricture is important for differential diagnosis and further treatment. This study aims to assess the differences of transpapillary biliary biopsy for malignant biliary strictures between cholangiocarcinoma and pancreatic cancer.MethodsFrom January 2010 to December 2013, we retrospectively studied 79 patients who suffered from biliary strictures and received transpapillary forceps biopsy after sphincterotomy for tissue sampling. The diagnostic sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of forceps biopsy were calculated in all cases for both cholangiocarcinoma and pancreatic cancer patients. Possible factors that distinguish malignant strictures from benign strictures and which could affect the accuracy of tissue sampling were analyzed.ResultsThere are 65 malignant and 14 benign biliary stricture patients enrolled. The malignant group has a significantly higher serum bilirubin level than the benign group, but age, clinical presentation, level of serum carcinoembryonic antigen (CEA), carbohydrate antigen (CA) 19-9, and alkaline phosphatase are not. The sensitivity, specificity, PPV, and NPV of forceps biopsy for biliary stricture are 53.85, 100, 100, and 31.82 %, respectively. The cholangiocarcinoma group has a higher sensitivity (73.53 versus 29.17 %, p < 0.001), older age, lower CA 19-9 level, and more common hepatic duct strictures than the pancreatic group. The age, serum CEA, CA 19-9 and the alkaline phosphatase level, serum bilirubin level >10 mg/dL, tissue sampling ≧3 are not significant factors affecting diagnostic accuracy in forceps biopsy for pancreatobiliary strictures. There is neither major bleeding nor perforation in our study.ConclusionsTranspapillary forceps biopsy of biliary strictures after sphincterotomy for tissue sampling is safe and a significantly higher sensitive method in cholangiocarcinoma but not in pancreatic cancer.

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“…The thick branch of the artery running near the biliary wall shown by the advanced CT indicated the cause of hemobilia in this case, which documents a very rare complication of forceps biopsy [2]. However, it seems to be difficult to avoid the thick branch of the artery while performing a transpapillary biopsy using ERCP.…”

Section: Discussionmentioning

confidence: 67%

“…Severe bleeding is rare [1][2][3] and invasive interventions including percutaneous radiologic hemostasis or surgery are required [4,5]. Recently, a covered self-expandable metal stent (CSEMS) was reported to be used for the treatment of massive hemobilia during ERCP [3,4].…”

Section: Introductionmentioning

confidence: 99%

Biliary hemostasis using an endoscopic plastic stent placement for uncontrolled hemobilia caused by transpapillary forceps biopsy (with video)

Shinjo

Matsubayashi

Matsui

et al. 2016

Clin J Gastroenterol

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A 78-year-old woman was referred to our hospital for the examination and treatment of jaundice. A transpapillary forceps biopsy for a long distal bile duct stricture was performed using endoscopic retrograde cholangiopancreatography. Immediately after the biopsy, massive bleeding was observed from the orifice of the papilla. Although hemobilia was pulsatile, an endoscopic biliary plastic stent placement was very effective in achieving hemostasis. However, a nasal biliary catheter was required because a blood clot clogged the stent on the following day. Although covered self-expandable metal stent (CSEMS) placement has been reported for achieving endoscopic hemostasis for bleeding, we chose to use a plastic stent to reduce the risk of post-procedure pancreatitis. The placement of both an endoscopic biliary plastic stent and a nasobiliary drainage catheter can be an alternative hemostatic tool to CSEMSs.

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Usefulness of endoscopic retrograde biliary biopsy using large-capacity forceps for extrahepatic biliary strictures: a prospective randomized study

Abstract: Large-capacity forceps performed better than standard forceps in terms of size, adequacy of the sample, submucosal sampling rate, and detection of neoplasia.

Cited by 26 publications

References 9 publications

Review article: Asia‐Pacific consensus recommendations on endoscopic tissue acquisition for biliary strictures

Review article: Asia‐Pacific consensus recommendations on endoscopic tissue acquisition for biliary strictures

Transpapillary biliary biopsy for malignant biliary strictures: comparison between cholangiocarcinoma and pancreatic cancer

Biliary hemostasis using an endoscopic plastic stent placement for uncontrolled hemobilia caused by transpapillary forceps biopsy (with video)

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