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.

A convenient and reliable method for endoscopic mapping biopsy of cholangiocarcinoma using a double-lumen cytology device

“…A mapping biopsy method using the pusher sheath of plastic stents to prevent the aforementioned drawbacks has been reported. 3 Although this method is also useful, the biopsy forceps cannot be inserted with the guidewire in place, and the forceps may be displaced from the intended branch during insertion. Furthermore, each time another branch is selected, there is the added step of recannulating the inner tube and the guidewire.…”

Self-expandable metallic stent placement for malignant biliary stricture using a novel device delivery system

“… 1 , 2 , 3 , 4 We previously reported the effectiveness of a biliary stent delivery system for evaluating the superficial longitudinal extension of perihilar cholangiocarcinoma. 5 This system was originally developed for placing a plastic stent in the biliary duct, and it is composed of a guide catheter and pusher tube. The system allows easy insertion of biopsy forceps through the pusher tube into the target bile duct.…”

Screening for Hilar Biliary Invasion in Ampullary Cancer Patients

“…However, cholangioscopy has di culty passing ampullary cancer. To avoid contact of the biopsy forceps with the tumor and to improve the diagnostic accuracy of hilar biliary biopsy for ampullary cancer patients, biliary biopsy with a catheter that introduces biopsy forceps could be useful [30,31]. When biliary biopsy with a catheter is unavailable, the combination method of biliary biopsy and IDUS should be considered.…”

“…In addition, ERC following IDUS was reported to be useful for diagnosing the lateral extension of biliary ductal cancer [24][25][26][27]. The diagnostic accuracy of mapping biopsy for lateral extension of biliary ductal cancer was reported to be 73.0-89.0% [28][29][30][31]. However, whether these methods are effective for investigating hilar invasion in ampullary cancer patients is unknown.…”