How many biopsies should be performed during percutaneous transhepatic cholangioscopy to diagnose biliary tract cancer?

Tamada, Kiichi; Kurihara, Kei; Tomiyama, Takeshi; Ohashi, Akiyoshi; Wada, Shinichi; Satoh, Yasuyuki; Miyata, Takamitsu; Ido, Kenichi; Sugano, Kentaro

doi:10.1016/s0016-5107(99)80014-5

Cited by 55 publications

(50 citation statements)

References 14 publications

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“…Although percutaneous transhepatic cholangioscopy (PTCS) is the best procedure to obtain a target biopsy, with sensitivity of 95%-96%, it requires an invasive technique compared with the transpapillary approach. [12][13][14][15] In the area of pancreatic cancer, telomerase activity detected in pancreatic juice is useful to detect occult small cancer. 16 In contrast, in bile juice, telomerase activity was detectable in only 5% of patients with bile duct carcinoma.…”

Section: Accurate Differentiation Of Benign and Malignant Biliary Stementioning

confidence: 99%

“…Extrahepatic bile duct carcinoma shows longitudinal spread along the bile duct, [12][13][14][15][33][34][39][40][41][42][43] often resulting in residual tumor at the surgical margin. Conventional cholangiography is inadequate for the assessment of longitudinal spread, previously reported.…”

Section: Assessment Of Longitudinal Cancer Extentmentioning

confidence: 99%

“…[12][13][14][15][33][34][41][42][43] Preoperative assessment of the longitudinal spread of bile duct cancer has been conducted with mapping biopsy, using PTCS. 12,15,33,34,43,44 With a combination of PTCS and cholangiography, accuracy of detection improved to 92%. 43 Autofluorescence cholangioscopy is a new modality which compensates for the false-negative results in mapping biopsy studies.…”

Section: Assessment Of Longitudinal Cancer Extentmentioning

confidence: 99%

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Diagnosis and non-surgical treatment of bile duct carcinoma: developments in the past decade

Tamada

Sugano

2000

Journal of Gastroenterology

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In the past decade, ultrasonography and magnetic resonance cholangiography have become useful modalities for the screening of bile duct cancer. Intraductal ultrasonography, using a thin-caliber (2.0 to 2.4 mm in diameter) and high-frequency (15 to 20 MHz) probe, has become a promising modality in assessing locoregional staging. For interventional therapy of unresectable bile duct carcinoma, metallic stents also became an excellent modality. However, tumor ingrowth and overgrowth into the mesh of stents are problems to be solved, and external radiation therapy is widely conducted to control the tumor. To improve the limitations of external radiation, brachytherapy, photodynamic therapy, and microwave coagulation therapy are conducted. However, these modalities are available in only a limited number of institutions even now. To predict the prognosis of the patients, approaches using molecular biology must be established.

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Section: Accurate Differentiation Of Benign and Malignant Biliary Stementioning

confidence: 99%

Section: Assessment Of Longitudinal Cancer Extentmentioning

confidence: 99%

Section: Assessment Of Longitudinal Cancer Extentmentioning

confidence: 99%

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Diagnosis and non-surgical treatment of bile duct carcinoma: developments in the past decade

Tamada

Sugano

2000

Journal of Gastroenterology

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“…When three biopsies were obtained from the margins of a stenotic cholangiocarcinoma rather than from the stricture itself, a positive diagnosis could be made in 95% cases. 29 In a retrospective case review of 44 consecutive patients with localized type bile duct cancer, Kawakami et al compared the diagnostic accuracy to detect intra-epithelial tumor spread (ITS) beyond the visible tumor on ERCP, ERCP with POC and ERCP with POC plus mapping biopsy. 30 ITS was correctly diagnosed in 22%, 77% and 100% cases, respectively.…”

Section: Indeterminate Biliary Strictures/filling Defectsmentioning

confidence: 99%

Per-oral cholangioscopy

Monga

Ramchandani²,

Reddy³

2011

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Direct endoscopic views of bile duct have been described in literature since the 1970s. Since then rapid strides have been made with the advent of technologically advanced systems with better image quality and maneuverability. The single operator semi-disposable per-oral cholangioscope and other novel methods such as the cholangioscopy access balloon are likely to revolutionize this field. Even though cholangioscopy is currently used primarily for characterization of indeterminate strictures and management of large bile duct stones, the diagnostic and therapeutic indications are likely to expand in future. The following is an overview of the currently available per-oral cholangioscopy equipments, indications for use and future directions.

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“…Extrahepatic bile duct carcinoma shows longitudinal spread to the hepatic side along the bile duct, [1][2][3][4][5][6][7][8][9] often resulting in residual tumor at the surgical margin. However, many investigators have reported that cholangiography failed to accurately assess the extent of longitudinal spread.…”

Section: Introductionmentioning

confidence: 99%

Limitations of three-dimensional intraductal ultrasonography in the assessment of longitudinal spread of extrahepatic bile duct carcinoma

Tamada

Yasuda

Nagai

et al. 2000

Journal of Gastroenterology

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We investigated the utility and limitations of three-dimensional intraductal ultrasonography (3D-IDUS), for the assessment of the extent of longitudinal cancer spread to the hepatic side by extrahepatic bile duct carcinoma. In eight patients with extrahepatic bile duct carcinoma. 3D-IDUS was used to assess longitudinal cancer extension to the hepatic side prior to resection. When the linear dimension of 3D-IDUS showed bile duct wall thickening that was connected to the tumor and which became thin at a point, it was determined to be the front formation of longitudinal cancer extension. The findings were examined in relation to histologic information from the resected specimen. Although 3D-IDUS showed front formation of wall thickening in two patients, it accurately reflected the histological margin of the longitudinal cancer extension in only one patient. In the other patient, the wall thickening was longer than the histological margin. When 3D-IDUS showed bile duct wall thickening without front formation (n = 2), the wall thickening was longer than the histological margin of the longitudinal cancer extension. Even when 3D-IDUS did not show wall thickening (n = 4), one of these patients showed cancer spread histologically. As a result, the accuracy in assessing longitudinal cancer extension by 3D-IDUS was only 50%. Even if the linear dimension of 3D-IDUS demonstrated front formation of thickening of the bile duct, it reflected not only cancer extension but also inflammatory wall thickening.

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How many biopsies should be performed during percutaneous transhepatic cholangioscopy to diagnose biliary tract cancer?

Cited by 55 publications

References 14 publications

Diagnosis and non-surgical treatment of bile duct carcinoma: developments in the past decade

Diagnosis and non-surgical treatment of bile duct carcinoma: developments in the past decade

Per-oral cholangioscopy

Limitations of three-dimensional intraductal ultrasonography in the assessment of longitudinal spread of extrahepatic bile duct carcinoma

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