Clin Endosc.  2018 Mar;51(2):174-180. 10.5946/ce.2017.082.

Usefulness of Endoscopic Transpapillary Tissue Sampling for Malignant Biliary Strictures and Predictive Factors of Diagnostic Accuracy

Affiliations
  • 1Department of Gastroenterology, Suzuka General Hospital, Suzuka, Japan. hiroki.tanaka@miekosei.or.jp
  • 2Department of Pathology, Suzuka General Hospital, Suzuka, Japan.
  • 3Department of Surgery, Suzuka General Hospital, Suzuka, Japan.

Abstract

BACKGROUND/AIMS
It is sometimes difficult to distinguish between malignant and benign biliary strictures using imaging studies alone, and pathological diagnosis is necessary. The aim of this study was to determine the usefulness of endoscopic transpapillary tissue sampling and factors predictive of diagnostic accuracy.
METHODS
From April 2008 to December 2014, 136 patients underwent endoscopic transpapillary tissue sampling for malignant biliary strictures. The cytological and histological findings were reported as negative, suspicious, or positive. Suspicious and positive findings were defined as pathologically positive.
RESULTS
The sensitivity was 65.0% for forceps biopsy, 49.5% for brush cytology, 46.2% for bile aspiration cytology, and 21.9% for endoscopic nasobiliary drainage cytology. The combination of these procedures improved the sensitivity (72.8%). Endoscopic transpapillary tissue sampling was more sensitive for lesions of biliary origin (91.4%) than for extrabiliary lesions (66.3%). In surgical cases, the sensitivity for tumors with an infiltrative growth pattern (53.3%) was significantly lower than for a tumor with an expanding or intermediate growth pattern (87.5%).
CONCLUSIONS
Combining procedures can improve diagnostic accuracy. It may be possible to predict the sensitivity of endoscopic transpapillary tissue sampling by evaluating the etiology and tumor growth pattern using preoperative imaging studies.

Keyword

Biliary tract neoplasms; Pancreatic neoplasms; Endoscopic retrograde cholangiography; Obstructive janudice

MeSH Terms

Bile
Biliary Tract Neoplasms
Biopsy
Constriction, Pathologic*
Diagnosis
Drainage
Humans
Pancreatic Neoplasms
Surgical Instruments

Cited by  2 articles

Factors Associated with Malignant Biliary Strictures in Patients with Atypical or Suspicious Cells on Brush Cytology
Ji Young Park, Tae Joo Jeon
Clin Endosc. 2019;52(2):168-174.    doi: 10.5946/ce.2018.105.

Diagnosis of Malignant Biliary Stricture: More is Better
Hyun Jik Lee, Kwang Bum Cho
Clin Endosc. 2018;51(2):115-117.    doi: 10.5946/ce.2018.035.


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