Usefulness of transpapillary bile duct brushing cytology and forceps biopsy for improved diagnosis in patients with biliary strictures

2007 ◽  
Vol 22 (10) ◽  
pp. 1615-1620 ◽  
Author(s):  
Yasuhiro Kitajima ◽  
Hirotaka Ohara ◽  
Takahiro Nakazawa ◽  
Tomoaki Ando ◽  
Kazuki Hayashi ◽  
...  
Keyword(s):  
Bile Duct ◽  
Biliary Strictures ◽  
Forceps Biopsy ◽  
Brushing Cytology

Endobiliary jumbo forceps biopsy as a technique for diagnosing bile duct malignancies.

2012 ◽  
Vol 30 (4_suppl) ◽  
pp. 197-197
Author(s):  
Michael H. Hsu ◽  
Rajeev Tummuru ◽  
Abhitabh Patil
Keyword(s):  
Bile Duct ◽  
Surgical Resection ◽  
Fine Needle Aspiration ◽  
Biliary Stricture ◽  
Needle Aspiration ◽  
Biopsy Forceps ◽  
Biliary Strictures ◽  
Forceps Biopsy ◽  
Fine Needle

197 Background: Pancreaticobiliary cancers are difficult to diagnose early and have a high associated mortality. Current methods of obtaining pathologic specimens from a biliary stricture include fine-needle aspiration, brush cytology, and endobiliary forceps biopsy. Among these forceps biopsy is the best, but is frequently limited by its low sensitivity (56%). The goal of this study is to evaluate the diagnostic yield and safety of jumbo forceps biopsies taken from the bile duct. Methods: All patients who presented to a single, tertiary academic referral center from July 2009 to July 2010 with a non-anastomotic biliary stricture were studied. This resulted in 9 patients with common bile duct strictures – 3 male and 6 female (ages 29-83, mean 61). All subjects underwent ERCP by the same gastroenterologist with endobiliary jumbo forceps biopsy using the Boston Scientific Radial Jaw 4 jumbo biopsy forceps. Specimens obtained were compared to available specimens obtained via fine needle aspiration, cytologic brushing or surgical resection. Patients with benign results were followed clinically for 1 year. Results: Three patients had benign biliary strictures as determined by clinical follow-up or surgical resection specimen. Jumbo forceps biopsy diagnosed a benign entity in 100% of these cases. Among the remaining 6 patients with malignant strictures, jumbo biopsy diagnosed a malignancy in 83% of cases. Tissue obtained was deemed adequate for histologic evaluation in 8 of 9 patients. The exception was recognized at the time of the procedure and was attributed to the technical inability to adequately open the biopsy forceps within the bile duct. Of the technically successful cases, 100% yielded an accurate histologic diagnosis as determined by concordant alternative sampling or clinical follow-up. In the 90 days following jumbo forceps biopsy, there were no adverse events such as bleeding, cholangitis, pancreatitis, perforation, peritonitis, or need for hospitalization. Conclusions: In our limited study, the use of jumbo forceps biopsies is safe and, when technically feasible, has a very high yield in evaluating biliary strictures. Larger studies are needed to confirm our findings.

ERCP TISSUE SAMPLING FROM COMMON BILE DUCT STRICTURES: BRUSH CITOLOGY AND INTRADUCTAL FORCEPS BIOPSY – WHICH ONE SHOULD I PERFORM FIRST?

2019 ◽  
Author(s):  
N Zaragoza Velasco ◽  
M Albuquerque Miranda ◽  
JM Miñana ◽  
M Figa Francesch ◽  
A Vargas García ◽  
...  
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Tissue Sampling ◽  
Forceps Biopsy

scholarly journals Etiological classification and treatment strategies for secondary bile duct dilatation

2020 ◽  
pp. 153537022096676
Author(s):  
Yunfu Lv ◽  
Ning Liu ◽  
Hongfei Wu ◽  
Zhuori Li
Keyword(s):  
Bile Duct ◽  
Extrahepatic Bile Duct ◽  
Treatment Strategies ◽  
Extensive Literature ◽  
Common Condition ◽  
Endoscopic Dilation ◽  
Biliary Strictures ◽  
Bile Duct Dilatation ◽  
Duct Dilatation ◽  
Classification And Treatment

Secondary intra- and extrahepatic bile duct dilatation is a very common condition that can be caused by several diseases. However, it has been rarely discussed in the specialized literature. Moreover, no distinct etiology can be determined in some cases, which hampers the diagnosis and treatment. Here, we discuss the etiological classification and treatment strategies of secondary intra- and extrahepatic bile duct dilatation based on an extensive literature review, as well as our experimental research and clinical experience. The etiology of secondary intra- and extrahepatic bile duct dilatation can be classified in different ways. From a clinicopathological perspective, it can be classified into obstruction-, lesion-, and compression-induced dilatation. Treatment varies depending on the cause. For example, endoscopic dilation or stenting is used for biliary strictures, laparoscopic choledochectomy for stone removal, and resection for cholangiocarcinoma.

scholarly journals Extraluminal recanalization for postoperative biliary obstruction using transseptal needle

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Hiroki Horinouchi ◽  
Eisuke Ueshima ◽  
Keitaro Sofue ◽  
Shohei Komatsu ◽  
Takuya Okada ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Bile Duct ◽  
Biliary Obstruction ◽  
Hepatic Duct ◽  
Drainage Tube ◽  
Biliary Strictures ◽  
Hepatic Bile ◽  
Hepatic Bile Duct ◽  
Benign Biliary Strictures ◽  
The Right

Abstract Background Postoperative biliary strictures are commonly related to accidental bile duct injuries or occur at the site of biliary anastomosis. The first-line treatment for benign biliary strictures is endoscopic therapy, which is less invasive and repeatable. However, recanalization for biliary complete obstruction is technically challenging to treat. The present report describes a successful case of treatment by extraluminal recanalization for postoperative biliary obstruction using a transseptal needle. Case presentation A 66-year-old woman had undergone caudal lobectomy for the treatment of hepatocellular carcinoma. The posterior segmental branch of the bile duct was injured and repaired intraoperatively. Three months after the surgery, the patient had developed biliary leakage from the right hepatic bile duct, resulting in complete biliary obstruction. Since intraluminal recanalization with conventional endoscopic and percutaneous approaches with a guidewire failed, extraluminal recanalization using a transseptal needle with an internal lumen via percutaneous approach was performed under fluoroscopic guidance. The left lateral inferior segmental duct was punctured, and an 8-F transseptal sheath was introduced into the ostium of right hepatic duct. A transseptal needle was advanced, and the right hepatic duct was punctured by targeting an inflated balloon that was placed at the end of the obstructed right hepatic bile duct. After confirming successful puncture using contrast agent injected through the internal lumen of the needle, a 0.014-in. guidewire was advanced into the right hepatic duct. Finally, an 8.5-F internal–external biliary drainage tube was successfully placed without complications. One month after the procedure, the drainage tube was replaced with a 10.2-F drainage tube to dilate the created tract. Subsequent endoscopic internalization was performed 5 months after the procedure. At the 1-year follow-up examination, there was no sign of biliary obstruction and recurrence of hepatocellular carcinoma. Conclusions Recanalization using a transseptal needle can be an alternative technique for rigid biliary obstruction when conventional techniques fail.

Biliary strictures as a cause of primary intrahepatic bile duct stones

1986 ◽  
Vol 10 (5) ◽  
pp. 867-874 ◽  
Author(s):  
Yoshiro Matsumoto ◽  
Hideki Fujii ◽  
Masakazu Yoshioka ◽  
Takayoshi Sekikawa ◽  
Toshisue Wada ◽  
...  
Keyword(s):  
Bile Duct ◽  
Intrahepatic Bile Duct ◽  
Bile Duct Stones ◽  
Biliary Strictures

scholarly journals PTH-033 A Systematic Approach to Standard Endoscopic Sampling of Bile Duct Strictures is Highly Accurate in the Diagnosis of Biliary Strictures: Abstract PTH-033 Table 1

Gut ◽  
2013 ◽  
Vol 62 (Suppl 1) ◽  
pp. A224.1-A224
Author(s):  
O Noorullah ◽  
V P K Lekharaju ◽  
C W Wadsworth ◽  
K Brougham ◽  
N Stern ◽  
...  
Keyword(s):  
Bile Duct ◽  
Systematic Approach ◽  
Biliary Strictures

Dilation catheter-guided mini-forceps biopsy improves the diagnostic accuracy of malignant biliary strictures

Endoscopy ◽  
2018 ◽  
Vol 50 (08) ◽  
pp. 809-812 ◽  
Author(s):  
Ying-Chun Ren ◽  
Chun-Lan Huang ◽  
Su-Min Chen ◽  
Qiu-Yan Zhao ◽  
Xin-Jian Wan ◽  
...  
Keyword(s):  
Biliary Stricture ◽  
The Novel ◽  
Biliary Strictures ◽  
Brush Cytology ◽  
Accuracy Rate ◽  
Endoscopic Retrograde ◽  
Tissue Samples ◽  
Forceps Biopsy ◽  
Positive Rate ◽  
Malignant Biliary Stricture

Abstract Background Tissue sampling for biliary stricture is important for differential diagnosis and further treatment. The aim of this study was to assess a novel dilation catheter-guided mini-forceps biopsy (DCMB) method in the diagnosis of malignant biliary strictures. Methods 42 patients with malignant biliary stricture who underwent both brush cytology and DCMB during endoscopic retrograde cholangiopancreatography between October 2014 and November 2015 were retrospectively included. During DCMB, the mini biopsy forceps was introduced into the biliary stricture through the dilation catheter, and then the position and direction of the forceps were adjusted to obtain tissue samples. Results The positive rate of DCMB was significantly higher than that of brush cytology (81.0 % [34/42] vs. 38.1 % [16/42]; P < 0.001). No severe complications occurred; three patients (7.1 %) experienced mild procedure-related acute pancreatitis. Conclusions The novel DCMB technique was a practical, safe, efficient, and low-costing method for diagnosing malignant biliary stricture with a high accuracy rate.

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