Abstract
Tissue acquisition for endoscopic retrograde cholangiopancreatography (ERCP) is the key step in the assessment of patients with indeterminate biliary strictures. Patients with biliary strictures are characterized by clinical presentation, laboratory testing, imaging studies, and pathological results. Tissue sampling and pathological confirmation at ERCP are essential for patients with malignant biliary strictures who are considered for aggressive surgical management or are candidates for chemotherapy and/or radiation therapy. There are several tissue sampling methods at ERCP including mucosal brushing and transmucosal fine needle aspiration for cytologic examination and mucosal biopsies using a variety of equipments for histological analysis [1]. However, the pathological results of tissue acquisition remain dissatisfied [2]. Many factors causing low diagnostic rate are elucidated, including scirrhous nature of the tumors, low sample sizes acquired, and difficulty in target lesion. Several improved methods and modalities are studied to improve its accuracy, including direct visualization cholangiopancreatoscopy-assisted methods.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
De Bellis M, Sherman S, Fogel EL, et al. Tissue sampling at ERCP in suspected malignant biliary strictures (Part 2). Gastrointest Endosc. 2002;56:720–30.
Burnett AS, Calvert TJ, Chokshi RJ. Sensitivity of endoscopic retrograde cholangiopancreatography standard cytology: 10-y review of the literature. J Surg Res. 2013;184:304–11.
Ponchon T, Gagnon P, Berger F, et al. Value of endobiliary brush cytology and biopsies for the diagnosis of malignant bile duct stenosis: results of a prospective study. Gastrointest Endosc. 1995;42:565–72.
Lee JG, Leung JW, Baillie J, et al. Benign, dysplastic, or malignant--making sense of endoscopic bile duct brush cytology: results in 149 consecutive patients. Am J Gastroenterol. 1995;90:722–6.
Jailwala J, Fogel EL, Sherman S, et al. Triple-tissue sampling at ERCP in malignant biliary obstruction. Gastrointest Endosc. 2000;51:383–90.
Ornellas LC, Santos Gda C, Nakao FS, et al. Comparison between endoscopic brush cytology performed before and after biliary stricture dilation for cancer detection. Arq Gastroenterol. 2006;43:20–3.
Weber A, von Weyhern C, Fend F, et al. Endoscopic transpapillary brush cytology and forceps biopsy in patients with hilar cholangiocarcinoma. World J Gastroenterol. 2008;14:1097–101.
Fogel EL, deBellis M, McHenry L, et al. Effectiveness of a new long cytology brush in the evaluation of malignant biliary obstruction: a prospective study. Gastrointest Endosc. 2006;63:71–7.
De Bellis M, Sherman S, Fogel EL, et al. Tissue sampling at ERCP in suspected malignant biliary strictures (Part 1). Gastrointest Endosc. 2002;56:552–61.
Navaneethan U, Njei B, Lourdusamy V, et al. Comparative effectiveness of biliary brush cytology and intraductal biopsy for detection of malignant biliary strictures: a systematic review and meta-analysis. Gastrointest Endosc. 2015;81:168–76.
Suzuki R, Thosani N, Annangi S, et al. Diagnostic yield of endoscopic cholangiopancreatography-based cytology for distinguishing malignant and benign intraductal papillary mucinous neoplasm: systemic review and meta-analysis. Dig Endosc. 2014;26:586–93.
Barkun A, Liu J, Carpenter S, et al. Update on endoscopic tissue sampling devices. Gastrointest Endosc. 2006;63:741–5.
Foutch PG, Harlan JR, Kerr D, et al. Wire-guided brush cytology: a new endoscopic method for diagnosis of bile duct cancer. Gastrointest Endosc. 1989;35:243–7.
de Bellis M, Fogel EL, Sherman S, et al. Influence of stricture dilation and repeat brushing on the cancer detection rate of brush cytology in the evaluation of malignant biliary obstruction. Gastrointest Endosc. 2003;58:176–82.
Schoefl R, Haefner M, Wrba F, et al. Forceps biopsy and brush cytology during endoscopic retrograde cholangiopancreatography for the diagnosis of biliary stenoses. Scand J Gastroenterol. 1997;32:363–8.
Yang R, Naritoku W, Laine L. Prospective, randomized comparison of disposable and reusable biopsy forceps in gastrointestinal endoscopy. Gastrointest Endosc. 1994;40:671–4.
Woods KL, Anand BS, Cole RA, et al. Influence of endoscopic biopsy forceps characteristics on tissue specimens: results of a prospective randomized study. Gastrointest Endosc. 1999;49:177–83.
Lin LF, Siauw CP, Ho KS, et al. Guidewire technique for endoscopic transpapillary procurement of bile duct biopsy specimens without endoscopic sphincterotomy. Gastrointest Endosc. 2003;58:272–4.
Aabakken L, Karesen R, Serck-Hanssen A, et al. Transpapillary biopsies and brush cytology from the common bile duct. Endoscopy. 1986;18:49–51.
Rustgi AK, Kelsey PB, Guelrud M, et al. Malignant tumors of the bile ducts: diagnosis by biopsy during endoscopic cannulation. Gastrointest Endosc. 1989;3:248–51.
Barkun A, Liu J, Carpenter S, et al. Biliary and pancreatic sampling devices during ERCP. Gastrointest Endosc. 1996;43:775–8.
Howell DA, Beveridge RP, Bosco J, et al. Endoscopic needle aspiration biopsy at ERCP in the diagnosis of biliary strictures. Gastrointest Endosc. 1992;38:531–5.
Fukuda Y, Tsuyuguchi T, Sakai Y, et al. Diagnostic utility of peroral cholangioscopy for various bile duct lesions. Gastrointest Endosc. 2005;62:374–82.
Shah RJ, Langer DA, Antillon MR, et al. Cholangioscopy and cholangioscopic forceps biopsy in patients with indeterminate pancreaticobiliary pathology. Clin Gastroenterol Hepatol. 2006;4:219–25.
Moon JH, Terheggen G, Choi HJ, et al. Peroral cholangioscopy: diagnostic and therapeutic applications. Gastroenterology. 2013;144:276–82.
Draganov PV, Chauhan S, Wagh MS, et al. Diagnostic accuracy of conventional and cholangioscopy-guided sampling of indeterminate biliary lesions at the time of ERCP: a prospective, long-term follow-up study. Gastrointest Endosc. 2012;75:347–53.
Sun X, Zhou Z, Tian J, et al. Is single-operator peroral cholangioscopy a useful tool for the diagnosis of indeterminate biliary lesion? A systematic review and meta-analysis. Gastrointest Endosc. 2015;82:79–87.
Navaneethan U, Hasan MK, Kommaraju K, et al. Digital single-operator cholangiopancreatoscopy in the diagnosis and management of pancreatobiliary disorders: a multicenter clinical experience (with video). Gastrointest Endosc. 2016;84:649–55.
Ryan ME, Baldauf MC. Comparison of flow cytometry for DNA content and brush cytology for detection of malignancy in pancreaticobiliary strictures. Gastrointest Endosc. 1994;40:133–9.
Baron TH, Harewood GC, Rumalla A, et al. A prospective comparison of digital image analysis and routine cytology for the identification of malignancy in biliary tract strictures. Clin Gastroenterol Hepatol. 2004;2:214–9.
Burnett AS, Bailey J, Oliver JB, et al. Sensitivity of alternative testing for pancreaticobiliary cancer: a 10-y review of the literature. J Surg Res. 2014;190:535–47.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2018 Springer Nature Singapore Pte Ltd.
About this chapter
Cite this chapter
Huang, WH. (2018). ERCP for Biliary-Pancreatic Tissue Acquisition. In: Lai, KH., Mo, LR., Wang, HP. (eds) Biliopancreatic Endoscopy. Springer, Singapore. https://doi.org/10.1007/978-981-10-4367-3_10
Download citation
DOI: https://doi.org/10.1007/978-981-10-4367-3_10
Published:
Publisher Name: Springer, Singapore
Print ISBN: 978-981-10-4366-6
Online ISBN: 978-981-10-4367-3
eBook Packages: MedicineMedicine (R0)