Usefulness of Endoscopic Brush Cytology from Malignant Biliary Obstruction

Park, Byeong Heon; Dong, Seok Ho; Lee, Byoung Wook; Hwang, You Cheol; Kim, Su Young; Lee, Dong Gun; Kim, Hyo Jong; Kim, Byung Ho; Lee, Joung Il; Chang, Young Woon; Chang, Rin

Abstract

BACKGROUNDS/AIMS: In patients with obstructive jaundice due to malignant biliary tract stricture, a tissue diagnosis is essential because the various treatment options are available. The tissue biopsy from the biliary tree is difficult because of the focal, sclerotic, small annular nature and lower celluarity. Brush cytology is an effective method for obtaining a tissue from bile duct stricture, and the diagnostic sensitivity of endoscopic brush cytology is reported as between 40% and 70% from malignant bile duct strictures. In this study, we analyzed the diagnostic value of endoscopic brush cytology in patient with extrahepatic bile duct strictures.
METHODS
The eight patients with extrahepatic bile duct strictures diagnosed with endoscopic retrograde cholangiopancreatography underwent endoscopic brush cytology and aspiration bile cytology. Brushing were taken using a Greenen cytology brush passed with a guide wire through the stricture.
RESULTS
The final diagnoses were made by surgical pathology and clinical follow-up. The sensitivity of brush cytology (62.5%, 5/8) was significantly higher than the sensitivity of bile cytology (0%; 0/8). No procedure related complication occured.
CONCLUSIONS
Endoscopic brush cytology would be an effective and a relatively safe method for tissue diagnosis in patients with malignant biliary obstruction.