A novel technique for mapping biopsy of bile duct cancer

Abstract Background Accurate preoperative assessment of the longitudinal extension of perihilar cholangiocarcinoma (PHCC) is essential for treatment planning. Mapping biopsies for PHCC remain challenging owing to technical difficulties and insufficient sample amounts. The aim of this study was to investigate the usefulness of a novel technique for mapping biopsies of PHCC. Methods Our novel method focused on a biliary stent delivery system for mapping biopsies. Fifty patients with PHCC undergoing endoscopic transpapillary mapping biopsy using the novel method were reviewed from August 2015 to June 2019. Results The median number of biopsy samples was six (range 1 – 17), and the rate of adequate sampling was 91.4 % (266 /291). Biopsy from the intrahepatic bile duct was possible in 82.0 % of patients (41 /50), and negative margins were confirmed in the resected specimens from 34 /39 patients who underwent surgery (87.2 %). None of the patients had post-endoscopic retrograde cholangiopancreatography pancreatitis. Conclusions With our novel method, accurate assessment of the longitudinal extension of PHCC might be expected with minimal trauma to the duodenal papilla.

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A novel technique for endoscopic transpapillary “mapping biopsy specimens” of superficial intraductal spread of bile duct carcinoma (with videos)

Gastrointestinal Endoscopy ◽

10.1016/j.gie.2014.01.040 ◽

2014 ◽

Vol 79 (6) ◽

pp. 1020-1025 ◽

Cited By ~ 10

Author(s):

Susumu Hijioka ◽

Kazuo Hara ◽

Nobumasa Mizuno ◽

Hiroshi Imaoka ◽

Mohamed A. Mekky ◽

...

Keyword(s):

Bile Duct ◽

Bile Duct Carcinoma ◽

Duct Carcinoma ◽

Intraductal Spread ◽

Novel Technique ◽

Biopsy Specimens ◽

Mapping Biopsy

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Preoperative perihilar cholangiocarcinoma assessment using virtual endoscopic imaging magnetic resonance cholangioscopy

Endoscopy International Open ◽

10.1055/a-1401-9962 ◽

2021 ◽

Vol 09 (07) ◽

pp. E1158-E1163

Author(s):

Mitsuru Okuno ◽

Tsuyoshi Mukai ◽

Shota Iwata ◽

Ryuichi Tezuka ◽

Naoya Mita ◽

...

Keyword(s):

Bile Duct ◽

Magnetic Resonance ◽

Three Dimensional ◽

Preoperative Assessment ◽

Perihilar Cholangiocarcinoma ◽

Imaging Method ◽

Endoscopic Imaging ◽

Novel Method ◽

Magnetic Resonance Imaging Mri ◽

Pass Through

Abstract Background and study aims Preoperative assessment of the superficial ductal spread (SDS) of perihilar cholangiocarcinoma (PCCA) is important for determining its resectability. A virtual endoscopic imaging method, magnetic resonance cholangioscopy (MRCS), wherein a three-dimensional image is created from magnetic resonance imaging (MRI) data, can evaluate all aspects of arbitrary bile ducts. Patients and methods Overall, 15 patients with PCCA who underwent preoperative MRI were enrolled. All patients underwent surgical treatment. Results MRCS could be performed based on preoperative MRI data in all patients. MRCS could not be used in one patient due to debris in the obstructed bile duct. The remaining 14 patients (93 %) were diagnosed with obstructed bile duct or irregular surface of the bile duct, signifying tumor invasion. The accuracy rate of diagnosing the SDS was 93 % (14/15). Seven patients underwent preoperative peroral cholangioscopy; the scope could not pass through the tumor in three patients. In these three patients, MRCS was able to be use dtoevaluate the obstructed side of the bile duct and faciliated accurate diagnosis of SDS. Conclusions MRCS can be used to noninvasively evaluate the bile duct in all directions. This novel method makes it easy to create virtual images and can be useful for diagnosing the preoperative SDS of PCCA.

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