Endoscopy 2020; 52(S 01): S182
DOI: 10.1055/s-0040-1704566
ESGE Days 2020 ePoster Podium presentations
Friday, April 24, 2020 14:30 – 15:00 Biliary tissue acquistion ePoster Podium 2
© Georg Thieme Verlag KG Stuttgart · New York

OPTIMIZING OUTCOMES OF TISSUE ACQUISITION FOR DIAGNOSIS OF BILIARY LESION IN ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY

S Kim
1   Korea University Anam Hospital, Gastroenterology, Seoul, Korea, Republic of
,
HS Lee
1   Korea University Anam Hospital, Gastroenterology, Seoul, Korea, Republic of
,
KW Lee
1   Korea University Anam Hospital, Gastroenterology, Seoul, Korea, Republic of
,
S Jang
1   Korea University Anam Hospital, Gastroenterology, Seoul, Korea, Republic of
,
SH Kim
1   Korea University Anam Hospital, Gastroenterology, Seoul, Korea, Republic of
,
HJ Jeon
1   Korea University Anam Hospital, Gastroenterology, Seoul, Korea, Republic of
,
SJ Choi
1   Korea University Anam Hospital, Gastroenterology, Seoul, Korea, Republic of
,
JM Lee
1   Korea University Anam Hospital, Gastroenterology, Seoul, Korea, Republic of
,
HS Choi
1   Korea University Anam Hospital, Gastroenterology, Seoul, Korea, Republic of
,
ES Kim
1   Korea University Anam Hospital, Gastroenterology, Seoul, Korea, Republic of
,
B Keum
1   Korea University Anam Hospital, Gastroenterology, Seoul, Korea, Republic of
,
YT Jeen
1   Korea University Anam Hospital, Gastroenterology, Seoul, Korea, Republic of
,
CD Kim
1   Korea University Anam Hospital, Gastroenterology, Seoul, Korea, Republic of
,
CH Oh
1   Kyunghee University Hospital, Gastroenterology, Seoul, Korea, Republic of
,
SH Dong
1   Kyunghee University Hospital, Gastroenterology, Seoul, Korea, Republic of
› Author Affiliations
Further Information

Publication History

Publication Date:
23 April 2020 (online)

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    Aims Accurate diagnosis of biliary lesions remains a clinical challenge due to the difficulty of obtaining an adequate specimen. Bile aspiration, brush cytology and forcep biopsy are well-known methods of obtaining tissue in endoscopic retrograde cholangiopancreatography(ERCP). Recently, single-use cholangioscopy(Spyglass, Boston scientific, USA) has been developed to improve diagnostic capability of ERCP. This study is aimed to compare the performance of each method and optimize the strategy for biliary tissue sampling.

    Methods Retrospective chart review was performed of ERCP procedures in two tertiary medical centers between January 2013 and December 2018. Diagnostic yields were compared according to each four methods; Bile aspiration, brush cytology, forcep biopsy of ERCP and biopsy using single-use cholangioscopy. The outcomes of single or combination of techniques were analyzed to find the optimal strategy of tissue sampling.

    Results Data of 416 patients underwent bile duct sampling using ERCP was collected. 328 patients had finally diagnosed as malignant disease. The sensitivity of each method were followed as bile aspiration 28.5%, brush cytology 53.7%, forcep biopsy 62.7% and single-use cholangioscopy biopsy 80.1%. The combination of bile aspiration, brush cytology and forcep biopsy showed a better diagnostic performance (sensitivity 72.2%, accuracy 78.6%, negative predictive value 51.6%) than single method only. Biliary sampling using single-use cholangioscopy biopsy showed better diagnostic accuracy than other methods. There was no significant difference between groups “with” and “without” brush tip-cutting (53.1% vs. 55.8% in sensitivity).

    Conclusions Our study suggests that forcep biopsy using single-use cholangioscopy is an effective method for tissue sampling in ERCP. However, each single method have a limited sensitivity for the diagnosis of malignant biliary strictures. A combination of methods can increase the sensitivity and accuracy for biliary strictures in ERCP.


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