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CardioVascular and Interventional Radiology
Published in: CardioVascular and Interventional Radiology 4/2012

01-08-2012 | Clinical Investigation

Cytological Sampling Versus Forceps Biopsy During Percutaneous Transhepatic Biliary Drainage and Analysis of Factors Predicting Success

Authors: C. R. Tapping, O. R. Byass, J. E. I. Cast

Published in: CardioVascular and Interventional Radiology | Issue 4/2012

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Abstract

Purpose

To assess the accuracy of cytological sampling and forceps biopsy in obstructing biliary lesions and to identify factors predictive of success.

Methods

Consecutive patients (n = 119) with suspected malignant inoperable obstructive jaundice treated with percutaneous transhepatic biliary drainage during 7 years were included (60 male; mean age 72.5 years). All patients underwent forceps biopsy plus cytological sampling by washing the forceps device in cytological solution. Patient history, procedural and pathological records, and clinical follow-up were reviewed. Statistical analysis included chi-square test and multivariate regression analysis.

Results

Histological diagnosis after forceps biopsy was more successful than cytology: Sensitivity was 78 versus 61%, and negative predictive value was 30 versus 19%. Cytology results were never positive when the forceps biopsy was negative. The cytological sample was negative and forceps sample positive in 2 cases of cholangiocarcinoma, 16 cases of pancreatic carcinoma, and 1 case of benign disease. Diagnostic accuracy was predicted by low bilirubin (p < 0.001), aspartate transaminase (p < 0.05), and white cell count (p ≤ 0.05).

Conclusions

This technique is safe and effective and is recommended for histological diagnosis during PTBD in patients with inoperable malignant biliary strictures. Diagnostic yield is greater when bilirubin levels are low and there is no sepsis; histological diagnosis by way of forceps biopsy renders cytological sampling unnecessary.
Literature
1.
Baron RL, Stanley RJ, Lee JK et al (1982) A prospective comparison of the evaluation of biliary obstruction using computed tomography and ultrasonography. Radiology 145(1):91–98PubMed
2.
Hall-Craggs MA, Lees WR (1986) Fine-needle aspiration biopsy: Pancreatic and biliary tumors. AJR Am J Roentgenol 147(2):399–403PubMed
3.
Xing GS, Geng JC, Han XW et al (2005) Endobiliary brush cytology during percutaneous transhepatic cholangiodrainage in patients with obstructive jaundice. Hepatobiliary Pancreat Dis Int 4(1):98–103PubMed
4.
Elyaderani MK, Gabriele OF (1980) Brush and forceps biopsy of biliary ducts via percutaneous transhepatic catheterization. Radiology 135(3):777–778PubMed
5.
Terasaki K, Wittich GR, Lycke G et al (1991) Percutaneous transluminal biopsy of biliary strictures with a bioptome. AJR Am J Roentgenol 156(1):77–78PubMed
6.
Kim CS, Han YM, Song HY et al (1992) Percutaneous transhepatic biliary biopsy using gastrofiberscopic biopsy forceps. J Korean Med Sci 7(4):325–332PubMed
7.
Donald JJ, Fache JS, Burhenne HJ (1993) Percutaneous transluminal biopsy of the biliary tract. Can Assoc Radiol J 44(3):185–188PubMed
8.
Tsai CC, Mo LR, Chou CY et al (1997) Percutaneous transhepatic transluminal forceps biopsy in obstructive jaundice. Hepatogastroenterology 44(15):770–773PubMed
9.
Savader SJ, Prescott CA, Lund GB, Osterman FA (1996) Intraductal biliary biopsy: comparison of three techniques. J Vasc Interv Radiol 7(5):743–750PubMedCrossRef
10.
Jung GS, Huh JD, Lee SU et al (2002) Bile duct: Analysis of percutaneous transluminal forceps biopsy in 130 patients suspected of having malignant biliary obstruction. Radiology 224(3):725–730PubMedCrossRef
11.
Tapping CR, Byass OR, Cast JE (2011) Percutaneous transhepatic biliary drainage (PTBD) with or without stenting—complications, re-stent rate, and a new risk stratification score. Eur Radiol 2011 May [Epub ahead of print]
12.
Savader SJ, Lynch FC, Radvany MG et al (1998) Single-specimen bile cytology: a prospective study of 80 patients with obstructive jaundice. J Vasc Interv Radiol 9(5):817–821PubMedCrossRef
13.
Ryan ME (1991) Cytologic brushings of ductal lesions during ERCP. Gastrointest Endosc 37(2):139–142PubMedCrossRef
14.
Cropper LD Jr, Gold RE (1983) Simplified brush biopsy of the bile ducts. Radiology 148(1):307–308PubMed
15.
Mendez G Jr, Russel E, Levi JU et al (1980) Percutaneous brush biopsy and internal drainage of biliary tree through endoprosthesis. AJR Am J Roentgenol 134(4):653–659PubMed
16.
Volmar KE, Vollmer RT, Routbort MJ et al (2006) Pancreatic and bile duct brushing cytology in 1000 cases: review of findings and comparison of preparation methods. Cancer 108(4):231–238PubMedCrossRef
17.
de Bellis M, Fogel EL, Sherman S et al (2003) Influence of stricture dilation and repeat brushing on the cancer detection rate of brush cytology in the evaluation of malignant biliary obstruction. Gastrointest Endosc 58(2):176–182PubMedCrossRef
18.
Byrne MF, Gerke H, Mitchell RM et al (2004) Yield of endoscopic ultrasound-guided fineneedle aspiration of bile duct lesions. Endoscopy 36(8):715–719PubMedCrossRef
19.
Nimura Y (1993) Staging of biliary carcinoma: cholangiography and cholangioscopy. Endoscopy 25(1):76–80PubMedCrossRef
20.
Sato M, Inoue H, Ogawa S et al (1998) Limitations of percutaneous transhepatic cholangioscopy for the diagnosis of the intramural extension of bile duct carcinoma. Endoscopy 30(3):281–288PubMedCrossRef
21.
Ryan ME (1991) Cytologic brushings of ductal lesions during ERCP. Gastrointest Endosc 37(2):139–142PubMedCrossRef
Metadata
Title
Cytological Sampling Versus Forceps Biopsy During Percutaneous Transhepatic Biliary Drainage and Analysis of Factors Predicting Success
Authors
C. R. Tapping
O. R. Byass
J. E. I. Cast
Publication date
01-08-2012
Publisher
Springer-Verlag
Published in
CardioVascular and Interventional Radiology / Issue 4/2012
Print ISSN: 0174-1551
Electronic ISSN: 1432-086X
DOI
https://doi.org/10.1007/s00270-011-0193-z

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