Comparison of the Diagnostic Performances of Same-session Endoscopic Ultrasound- and Endoscopic Retrograde Cholangiopancreatography-guided Tissue Sampling for Suspected Biliary Strictures at Different Primary Tumor Sites
10.4166/kjg.2019.73.4.213
- Author:
Seong Jae YEO
1
;
Chang Min CHO
;
Min Kyu JUNG
;
An Na SEO
;
Han Ik BAE
Author Information
1. Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Korea. cmcho@knu.ac.kr
- Publication Type:Original Article
- Keywords:
Endosonography;
Cholangiopancreatography, endoscopic retrograde;
Diagnosis;
Stricture
- MeSH:
Biopsy;
Biopsy, Fine-Needle;
Cholangiocarcinoma;
Cholangiopancreatography, Endoscopic Retrograde;
Constriction, Pathologic;
Diagnosis;
Endosonography;
Follow-Up Studies;
Humans;
Pancreatic Ducts;
Pancreatic Neoplasms;
Surgical Instruments
- From:The Korean Journal of Gastroenterology
2019;73(4):213-218
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND/AIMS: Determining the cause of suspected biliary stricture is often challenging in clinical practice. We aimed to compare the diagnostic yields of endoscopic ultrasound-guided tissue sampling (EUS-TS) and endoscopic retrograde cholangiopancreatography-guided tissue sampling (ERCP-TS) in patients with suspected biliary stricture at different primary lesions. METHODS: We enrolled patients who underwent same-session EUS- and ERCP-TS for the evaluation of suspected biliary stricture. Forceps biopsy and/or brush cytology of intraductal lesions and fine-needle aspiration for solid mass lesions were performed during ERCP and EUS, respectively. RESULTS: One hundred and twenty-five patients treated at our institution between January 2011 and September 2016, were initially considered for the study. However, 32 patients were excluded due to loss of follow-up (n=8) and ERCP-TS on the pancreatic duct (n=20) or periampullary lesions (n=4). Of the 93 patients included, 86 had a malignant tumor including cholangiocarcinoma (n=39), pancreatic cancer (n=37), and other malignancies (n=10). Seven patients had benign lesions. EUS-TS had higher rate of overall diagnostic accuracy than ERCP-TS (82.8% vs. 60.2%, p=0.001), and this was especially true for patients with a pancreatic lesion (84.4% vs. 51.1%, p=0.003). CONCLUSIONS: EUS-TS was found to be superior to ERCP-TS for evaluating suspected biliary strictures, especially those caused by pancreatic lesions.
