Yield of Endoscopic Ultrasound-Guided Fine-Needle Aspiration of Bile Duct Lesions

Byrne, Michael F.; Gerke, Henning; Mitchell, R. M.; Stiffler, Helen; McGrath, KM; Branch, Malcolm S.; Baillie, J; Jowell, Paul S.

doi:10.1055/s-2004-825657

Cited by 99 publications

(47 citation statements)

References 24 publications

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“…However, only 12 reports have described EUS-FNA for biliary disease. Table 4 shows an overview of EUS-FNA for the biliary tract [Frischer-Ravens et al 2000Rösch et al 2004, Lee et al 2004Eloubeidi et al 2004;Byrne et al 2004;Meara et al 2006;DeWitt et al 2006;Mohamadnejad et al 2011;Ohshima et al 2011;Nayar et al 2011;Weilert et al 2014]. According to those reports, sensitivity and accuracy have been widely reported as 43-100% and 54-100%, respectively.…”

Section: Discussionmentioning

confidence: 99%

“…Compared with ERCP, EUS-FNA offers high diagnostic sensitivity and accuracy for pancreatic tumors, as well as a low risk of adverse events. However, only a few reports have described EUS-FNA for biliary lesions [FrischerRavens et al 2000[FrischerRavens et al , 2004Rösch et al 2004;Lee et al 2004;Eloubeidi et al 2004;Byrne et al 2004;Meara et al 2006;DeWitt et al 2006;Mohamadnejad et al 2011;Ohshima et al 2011;Nayar et al 2011;Weilert et al 2014]. In addition, most of those reports examined results of EUS-FNA in cases that could not be diagnosed using ERCP.…”

mentioning

confidence: 99%

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EUS-guided FNA for biliary disease as first-line modality to obtain histological evidence

Onda

Ogura

Kurisu

et al. 2016

Therap Adv Gastroenterol

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Background: Few reports have described endoscopic ultrasound (EUS)-guided fine needle aspiration (FNA) for biliary lesions. In addition, adverse events were not completely examined in previous reports, due to the inclusion of cases in which biliary stents had already been placed. The present study aimed to investigate the diagnostic yield and adverse events of EUS-FNA for biliary lesions as the first-line diagnostic modality for consecutive prospectively registered patients. Methods: Inclusion criteria were as follows: (1) patients with suspected cholangiocarcinoma (CCA) based on computed tomography or other imaging modalities; (2) patients who had not previously undergone endoscopic retrograde cholangiopancreatography or EUS-FNA; (3) absence of surgically altered anatomy, such as Roux-en-Y anastomosis or duodenal obstruction caused by tumor invasion, through which an endoscope could not pass; and (4) provision of written informed consent to all procedures associated with the study. Results: A total of 47 consecutive patients with suspected CCA were registered to this study. Sensitivity and accuracy were 89% and 87%, respectively. On multivariate analysis, puncture site was the only factor associated with reduced diagnostic yield (hazard ration, 6.879; 95% confidence interval, 1.172–40.374; P = 0.033). Remarkably, no adverse events such as bleeding or bile leakage were associated with EUS-FNA in any of the 47 patients. Conclusions: Our results suggest that EUS-FNA can be safely performed for biliary disease without biliary stenting. Furthermore, this procedure may warrant use as the first-line diagnostic method, although our results need to be validated in future prospective studies.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

EUS-guided FNA for biliary disease as first-line modality to obtain histological evidence

Onda

Ogura

Kurisu

et al. 2016

Therap Adv Gastroenterol

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“…The only condition (either in patients with or without PSC) that does not require histological confirmation is biliary stricture associated with perihilar mass, hypertrophy-atrophy complex and vascular encasement, but this presentation is very rare. Endoscopic ultrasonography-guided fine-needle aspiration demonstrated a good diagnostic performance for discriminating benign versus malignant biliary strictures and without apparent risk of tumour seeding linked with the procedure [218][219][220][221][222] . As for iCCA, the risk of tumour seeding after transperitoneal biopsy of pCCA is based on limited evidence 223 .…”

Section: Clinical Presentation and Diagnosismentioning

confidence: 99%

Cholangiocarcinoma: current knowledge and future perspectives consensus statement from the European Network for the Study of Cholangiocarcinoma (ENS-CCA)

Bañales

Cardinale

Carpino

et al. 2016

Nat Rev Gastroenterol Hepatol

1,107

1,139

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“…The authors reported a diagnostic sensitivity of 86%. However, another group reported lower rates of diagnostic sensitivity (45%) for detection of bile duct lesions by using ultrasound guided fine needle aspiration [51] . EUS-FNA may represent an alternative approach in the diagnosis of cholangiocarcinoma, especially in patients with negative brush cytology and forceps biopsy findings.…”

Section: Eus Guided Fine-needle Aspirationmentioning

confidence: 99%

Diagnostic approaches for cholangiocarcinoma

Weber

Schmid²,

Prinz³

2008

WJG

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Cholangiocarcinomas arise from the epithelial cells of the bile ducts and are associated with poor prognosis. Despite new diagnostic approaches, the definite diagnosis of this malignancy continues to be challenging. Cholangiocarcinomas often grow longitudinally along the bile duct rather than in a radial direction. Thus, large tumor masses are frequently absent and imaging techniques, including ultrasound, CT, and MRI have only limited sensitivity. Tissue collection during endoscopic (ERCP) and/or percutaneous transhepatic (PTC) procedures are usually used to confirm a definitive diagnosis of cholangiocarcinoma. However, forceps biopsy and brush cytology provide positive results for malignancy in about only 50% of patients. Percutaneous and peroral cholangioscopy using fiber-optic techniques were therefore developed for direct visualization of the biliary tree, yielding additional information about endoscopic appearance and tumor extension, as well as a guided biopsy acquistion. Finally, endoscopic ultrasonography (EUS) complements endoscopic and percutaneous approaches and may provide a tissue diagnosis of tumors in the biliary region through fineneedle aspiration. In the future, new techniques allowing for early detection, including molecular m a r ke r s , s h o u l d b e d e ve l o p e d t o i m p rove t h e diagnostic sensitivity in this increasing tumor entity.

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Yield of Endoscopic Ultrasound-Guided Fine-Needle Aspiration of Bile Duct Lesions

Cited by 99 publications

References 24 publications

EUS-guided FNA for biliary disease as first-line modality to obtain histological evidence

EUS-guided FNA for biliary disease as first-line modality to obtain histological evidence

Cholangiocarcinoma: current knowledge and future perspectives consensus statement from the European Network for the Study of Cholangiocarcinoma (ENS-CCA)

Diagnostic approaches for cholangiocarcinoma

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