Efficacy of Bile Aspiration Plus Brushing to Diagnose Malignant Biliary Strictures During Endoscopic Retrograde Cholangiopancreatography: A Single Tertiary Center Experience

Aims Our study aimed to evaluate the diagnostic performance of bile aspiration associated with biliary brushing during ERCP to diagnose a malignant stricture, compared to brushing alone.

Methods In this prospective study, all patients undergoing ERCP to treat a malignant biliary stricture were included. After a biliary sphincterotomy, 3mL to 10mL of bile was aspirated into the brush catheter and collected before and after brushing (to yield three samples). Brushing was performed as commonly recommended.

Results Eighty seven patients (48 males, 39 females) were included; mean age 72±12.4 years. A final diagnosis of malignant stricture was established in 78 patients, including 63 cholangiocarcinomas. Specificity (Sp) and positive predictive values were 100 % for all samples. The diagnostic performance of the three-sample combination of bile aspiration+brushing+bile aspiration was significantly greater than brushing alone (P= 0.003): sensitivity (Se)=81.1 % vs. Se=56.9 %. The three-sample combination gave a negative predictive value of 85.3 %.

Conclusions Performing bile aspiration before and after brushing during ERCP increased significantly the ability to diagnose malignant bile-duct strictures, especially cholangiocarcinoma.

Citation: Amalou K, Belghanem F, Bousseloub A et al. OP137 EFFICACY OF BILE ASPIRATION PLUS BRUSHING TO DIAGNOSE MALIGNANT BILIARY STRICTURES DURING ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY: A SINGLE TERTIARY CENTER EXPERIENCE. Endoscopy 2021; 53: S56.

Publication History

Article published online:
19 March 2021