A novel method of forceps biopsy improves the diagnosis of proximal biliary malignancies

• Verfasst von: Kulaksiz, Hasan [VerfasserIn]
• Verfasst von: Strnad, Pavel [VerfasserIn]
• Verfasst von: Römpp, Achim [VerfasserIn]
• Verfasst von: von Figura, Guido [VerfasserIn]
• Verfasst von: Barth, Thomas [VerfasserIn]
• Verfasst von: Esposito, Irene [VerfasserIn]
• Verfasst von: Schirmacher, Peter [VerfasserIn]
• Verfasst von: Henne-Bruns, Doris [VerfasserIn]
• Verfasst von: Adler, Guido [VerfasserIn]
• Verfasst von: Stiehl, Adolf [VerfasserIn]
• Titel: A novel method of forceps biopsy improves the diagnosis of proximal biliary malignancies
• Verf.angabe: Hasan Kulaksiz, Pavel Strnad, Achim Römpp, Guido von Figura, Thomas Barth, Irene Esposito, Peter Schirmacher, Doris Henne-Bruns, Guido Adler, Adolf Stiehl
• E-Jahr: 2011
• Jahr: 08 January 2011
• Umfang: 6 S.
• Fussnoten: Gesehen am 11.07.2022
• Titel Quelle: Enthalten in: Digestive diseases and sciences
• Ort Quelle: Dordrecht : Springer Science + Business Media B.V., 1934
• Jahr Quelle: 2011
• Band/Heft Quelle: 56(2011), 2, Seite 596-601
• ISSN Quelle: 1573-2568
• DOI: doi:10.1007/s10620-010-1535-4
• Datenträger: Online-Ressource
• Sprache: eng
• Bibliogr. Hinweis: Erscheint auch als : Druck-Ausgabe: Kulaksiz, Hasan, 1969 - : A novel method of forceps biopsy improves the diagnosis of proximal biliary malignancies. - 2011
• Sach-SW: Cholangiocarcinoma
• Sach-SW: Double-balloon enteroscopy
• Sach-SW: Endoscopic retrograde cholangiography
• K10plus-PPN: 1809696348

Abstract

Background and Aims: Tissue specimen collection represents a cornerstone in diagnosis of proximal biliary tract malignancies offering great specificity, but only limited sensitivity. To improve the tumor detection rate, we developed a new method of forceps biopsy and compared it prospectively with endoscopic transpapillary brush cytology. Patients and Methods: 43 patients with proximal biliary stenoses, which were suspect for malignancy, undergoing endoscopic retrograde cholangiography were prospectively recruited and subjected to both biopsy [using a double-balloon enteroscopy (DBE) forceps under a guidance of a pusher and guiding catheter with guidewire] and transpapillary brush cytology. The cytological/histological findings were compared with the final clinical diagnosis. Results: 35 out of 43 patients had a malignant disease (33 cholangiocarcinomas, 1 hepatocellular carcinoma, 1 gallbladder carcinoma). The sensitivity of cytology and biopsy in these patients was 49 and 69%, respectively. The method with DBE forceps allowed a pinpoint biopsy of the biliary stenoses. Both methods had 100% specificity, and, when combined, 80% of malignant processes were detected. All patients with non-malignant conditions were correctly assigned by both methods. No clinically relevant complications were observed. Conclusions: The combination of forceps biopsy and transpapillary brush cytology is safe and offers superior detection rates compared to both methods alone, and therefore represents a promising approach in evaluation of proximal biliary tract processes.