Biliary guidewire facilitates bile duct biopsy and endoscopic drainage

Higashizawa, Toshihiko; Tamada, Kiichi; Tomiyama, Takeshi; Wada, Shinichi; Ohashi, Akiyoshi; Satoh, Yasuyuki; Gotoh, Yasuhiko; Miyata, Takamitsu; Ido, Kenichi; Sugano, Kentaro

doi:10.1046/j.1440-1746.2002.02691.x

Cited by 29 publications

(15 citation statements)

References 13 publications

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“…Cancer detection rates by using endobiliary forceps range from 44% to 89% for cholangiocarcinoma and 33% to 71% for pancreatic cancer. [34][35][36][37] However, endobiliary biopsy remains technically challenging (especially for proximal biliary strictures), and complications, including bleeding and biliary perforation, have been described.…”

Section: Ercpmentioning

confidence: 99%

Utility of EUS in patients with indeterminate biliary strictures and suspected extrahepatic cholangiocarcinoma (with videos)

Khashab

Fockens

Al‐Haddad

2012

Gastrointestinal Endoscopy

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Section: Ercpmentioning

confidence: 99%

Utility of EUS in patients with indeterminate biliary strictures and suspected extrahepatic cholangiocarcinoma (with videos)

Khashab

Fockens

Al‐Haddad

2012

Gastrointestinal Endoscopy

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“…We investigated papers about hilar obstruction due to malignant biliary stricture including HCC and cholangiocarcinoma (table 1) [10,11,12,13,14,15,16,17,18,19,20,21,22,23,24]. The successful drainage rate ranges from 72 to 100%.…”

Section: Drainagementioning

confidence: 99%

Hepatocellular Carcinoma with Obstructive Jaundice: Endoscopic and Percutaneous Biliary Drainage

Minami

Kudo²

2012

Dig Dis

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Among patients with later stage hepatocellular carcinoma (HCC), only 1–12% manifest obstructive jaundice as the initial complaint. Endoscopic retrograde biliary drainage (ERBD) and percutaneous transhepatic biliary drainage (PTBD) are the two main non-surgical treatment options for obstructive jaundice in patients with HCC. ERBD is usually the first-line treatment because of its low hemorrhage risk. Some have reported that the successful drainage rate ranges from 72 to 100%. Mean stent patency time and mean survival range from 1.0 to 15.9 and 2.8 to 12.3 months, respectively. PTBD is often an important second-line treatment when ERBD is impossible. With regard to materials, metallic stents offer the benefit of longer patency than plastic stents. The dominant effect of biliary drainage suggests that successful jaundice therapy could enhance anti-cancer treatment by increasing life expectancy, decreasing mortality, or both. We present an overview of the efficacy of endoscopic and percutaneous drainage for obstructive jaundice in patients with HCC who are not candidates for surgical resection and summarize the current indications and outcomes of reported clinical use.

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“…However, the sensitivity of TPB for the diagnosis of MBS is insufficient, ranging from 33% to 89%. In addition, the diagnostic yield of ERCP-based tissue sampling, including TPB, differed according to the nature of MBS [1,[17][18][19]. Several factors limit the ability of TPB to enhance the diagnostic yield for subjects with suspected MBS.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic approach using ERCP‐guided transpapillary forceps biopsy or EUS‐guided fine‐needle aspiration biopsy according to the nature of stricture segment for patients with suspected malignant biliary stricture

et al. 2017

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In malignant biliary stricture (MBS), the diagnostic accuracy of ERCP‐based tissue sampling is insufficient. EUS‐guided fine needle aspiration biopsy (EUS‐FNAB) is emerging as a reliable diagnostic procedure. This study aimed to evaluate the usefulness of a diagnostic approach using ERCP‐guided transpapillary forceps biopsy (TPB) or EUS‐FNAB according to the characteristics of suspected MBS. Consecutive patients diagnosed with suspected MBS with obstructive jaundice and/or cholangitis were enrolled prospectively. ERCP with intraductal ultrasonography (IDUS) and TPB were performed as initial diagnostic procedures. Based on the results of imaging studies and IDUS, all MBS were classified as extrinsic or intrinsic type. If the malignancy was not confirmed by TPB, EUS‐FNAB for extrinsic type or second TPB for intrinsic type was performed. Among a total of 178 patients, intrinsic and extrinsic types were detected in 88 and 90 patients, respectively. The diagnostic accuracy of first TPB was significantly higher in the intrinsic than in the extrinsic type (81.8% vs. 67.8, P = 0.023). In 33 patients with extrinsic type and negative for malignancy on first TPB, the diagnostic accuracy of EUS‐FNAB was 90.9%. In 19 patients with intrinsic type and negative for malignancy on first TPB, the diagnostic accuracy of second TPB was 84.2%. The diagnostic accuracies of the combination of initial TPB with EUS‐FNAB and second TPB were 96.7% and 96.6%, respectively. A diagnostic approach using EUS‐FNAB or TPB according to the origin of MBS is considered effective to improve the diagnostic accuracy of MBS with negative for malignancy on first TPB. (Clinical trial registration number: UMIN000016886).

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Biliary guidewire facilitates bile duct biopsy and endoscopic drainage

Abstract: A previously placed guidewire facilitates insertion of biopsy forceps and endoscopic biliary drainage. The histological diagnosis of cancer is more likely with bile duct cancer than with pancreatic cancer.

Cited by 29 publications

References 13 publications

Utility of EUS in patients with indeterminate biliary strictures and suspected extrahepatic cholangiocarcinoma (with videos)

Utility of EUS in patients with indeterminate biliary strictures and suspected extrahepatic cholangiocarcinoma (with videos)

Hepatocellular Carcinoma with Obstructive Jaundice: Endoscopic and Percutaneous Biliary Drainage

Diagnostic approach using ERCP‐guided transpapillary forceps biopsy or EUS‐guided fine‐needle aspiration biopsy according to the nature of stricture segment for patients with suspected malignant biliary stricture

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