The role of percutaneous transhepatic biliary biopsy in the diagnosis of patients with obstructive jaundice: an initial experience

Abstract

Objective: To evaluate the accuracy of percutaneous transhepatic biliary biopsy (PTBB) in patients with suspected biliary obstruction. Materials and methods: This was a retrospective analysis of 18 patients with obstructive jaundice who underwent PTBB. In each patient, three to ten fragments were collected from the lesion. The final diagnosis was confirmed in the pathology report. We also reviewed analyses of the results of laboratory tests performed before the procedure, as well as the Bismuth classification, clinical outcome, complications occurring during the procedure, access route, and materials used. Results: Technical success was achieved in 100% of the PTBB procedures. Among the 18 patients clinically diagnosed with bile duct stenosis, the pathological analysis confirmed that diagnosis in 17. In one case, the pathological findings were considered false-negative. The predominant tumor was cholangiocarcinoma (seen in 50% of the cases). Sixteen of the procedures (88.9%) were performed without complications. Transient hemobilia occurred in one case, and cholangitis occurred in another. Conclusion: PTBB is a safe, viable, simple technique with a high rate of true-positive results for the definitive diagnosis of obstructive jaundice.

Ultrasound evaluation of schistosomiasis-related morbidity among the Xakriabá people in the state of Minas Gerais, Brazil

“…Evaluation of the liver by imaging methods has been the subject of various recent studies in the radiology literature of Brazil (28)(29)(30)(31)(32) . The availability of affordable, good quality ultrasound machines has allowed the development of focused point-of-care ultrasound protocols applicable to tropical diseases.…”

Use of the LI-RADS classification in patients with cirrhosis due to infection with hepatitis B, C, or D, or infected with hepatitis B and D

“…Recent studies in the radiology literature of Brazil have emphasized the importance of imaging examinations in the evaluation of hepatic neoplasms (18)(19)(20)(21)(22)(23) . The present study used the LI-RADS classification system to analyze 38 patients infected with hepatitis viruses (HBV, HCV, HDV, or combinations thereof) who underwent CT. We found that approximately 32% of the patients presented with LI-RADS 5 observations (i.e., lesions diagnosed by imaging as classic HCC).…”

Biliary involvement in liver metastases: long-term experience with biliary biopsy from a single center

“…Percutaneous transluminal forceps biopsy (PTFB) of the bile duct performed during PTBD was first reported in 1980 ( 10 ) , and several studies have since demonstrated its safety and sensitivity, especially in cases of cholangiocarcinoma. Nevertheless, this technique is neither cited nor recommended in the ESMO guidelines ( 8 ) , probably because all published reports have involved only a small number of cases and the level of evidence therefore remains low ( 1 , 2 , 10 - 14 ) . To our knowledge, there have been no studies analyzing the safety and efficacy of PTFB in patients with metastatic biliary involvement.…”