Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Digestive Diseases and Sciences
Published in: Digestive Diseases and Sciences 7/2022

14-07-2021 | Ultrasound | Original Article

Brush Cytology, Forceps Biopsy, or Endoscopic Ultrasound-Guided Sampling for Diagnosis of Bile Duct Cancer: A Meta-Analysis

Authors: Seung Bae Yoon, Sung-Hoon Moon, Sung Woo Ko, Hyun Lim, Ho Suk Kang, Jong Hyeok Kim

Published in: Digestive Diseases and Sciences | Issue 7/2022

Login to get access

Abstract

Endoscopic sampling is essential for tissue diagnosis of cholangiocarcinoma (CCA). To evaluate and compare the diagnostic sensitivities of endoscopic retrograde cholangiopancreatography-guided brush cytology biopsy, and endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) in patients with CCA. A comprehensive literature search through multiple databases was conducted for articles published between January 1995 and August 2020. The pooled rates of sensitivity for the diagnosis of CCA and of adverse events were compared among brushing, biopsy, brushing & biopsy, and EUS-FNA. In total, 1123 patients with CCA (32 studies), 719 patients (20 studies), 358 patients (13 studies), and 422 patients (17 studies) were tested by brushing, biopsy, brushing & biopsy, and EUS-FNA, respectively. The pooled diagnostic sensitivity was 56.0% (95% confidence interval (CI) 48.8–63.1%, I2 = 83.0%) with brushing, 67.0% (95% CI 60.2–73.5%, I2 = 72.5%) with biopsy, 70.7% (95% CI 64.1–76.8%, I2 = 42.7%) with brushing & biopsy, and 73.6% (95% CI 64.7–81.5%, I2 = 74.7%) with EUS-FNA. The diagnostic sensitivity was significantly lower for brushing than for biopsy, brushing & biopsy, or EUS-FNA. No significant difference was noted in diagnostic sensitivities among biopsy, brushing & biopsy, and EUS-FNA. Adverse events were comparable between the groups. Intraductal biopsy, brushing & biopsy, and EUS-FNA had comparable efficacy and safety for the diagnosis of CCA. Brushing was the least sensitive diagnostic tool compared with intraductal biopsy or EUS-FNA. Given the modest diagnostic sensitivities of intraductal biopsy and EUS-FNA in the diagnosis of CCA, further studies for complementing these techniques with biomarkers may be needed.
Appendix
Available only for authorised users
Literature
1.
Banales JM, Marin JJG, Lamarca A et al. Cholangiocarcinoma 2020: the next horizon in mechanisms and management. Nat Rev Gastroenterol Hepatol. 2020;17:557–588.PubMedPubMedCentralCrossRef
2.
Khan SA, Davidson BR, Goldin RD et al. Guidelines for the diagnosis and treatment of cholangiocarcinoma: an update. Gut. 2012;61:1657–1669.PubMedCrossRef
3.
Rizvi S, Gores GJ. Pathogenesis, diagnosis, and management of cholangiocarcinoma. Gastroenterology. 2013;145:1215–1229.PubMedCrossRef
4.
Banales JM, Cardinale V, Carpino G et al. Expert consensus document: Cholangiocarcinoma: current knowledge and future perspectives consensus statement from the European Network for the Study of Cholangiocarcinoma (ENS-CCA). Nat Rev Gastroenterol Hepatol. 2016;13:261–280.PubMedCrossRef
5.
6.
Brandi G, Venturi M, Pantaleo MA, Ercolani G, GICO. Cholangiocarcinoma: Current opinion on clinical practice diagnostic and therapeutic algorithms: A review of the literature and a long-standing experience of a referral center. Dig Liver Dis 2016;48:231–241.PubMedCrossRef
7.
8.
Bowlus CL, Olson KA, Gershwin ME. Evaluation of indeterminate biliary strictures. Nat Rev Gastroenterol Hepatol. 2016;13:28–37.PubMedCrossRef
9.
Tummala P, Munigala S, Eloubeidi MA, Agarwal B. Patients with obstructive jaundice and biliary stricture +/- mass lesion on imaging: prevalence of malignancy and potential role of EUS-FNA. J Clin Gastroenterol. 2013;47:532–537.PubMedCrossRef
10.
Roos E, Hubers LM, Coelen RJS et al. IgG4-associated cholangitis in patients resected for presumed perihilar cholangiocarcinoma: a 30-year tertiary care experience. Am J Gastroenterol. 2018;113:765–772.PubMedCrossRef
11.
Navaneethan U, Njei B, Lourdusamy V, Konjeti R, Vargo JJ, Parsi MA. Comparative effectiveness of biliary brush cytology and intraductal biopsy for detection of malignant biliary strictures: a systematic review and meta-analysis. Gastrointest Endosc. 2015;81:168–176.PubMedCrossRef
12.
Forner A, Vidili G, Rengo M, Bujanda L, Ponz-Sarvise M, Lamarca A. Clinical presentation, diagnosis and staging of cholangiocarcinoma. Liver Int. 2019;39:98–107.PubMedCrossRef
13.
14.
American Society for Gastrointestinal Endoscopy Standards of Practice C, Anderson MA, Appalaneni V et al. The role of endoscopy in the evaluation and treatment of patients with biliary neoplasia. Gastrointest Endosc. 2013;77:167–174.CrossRef
15.
Rosch T, Hofrichter K, Frimberger E et al. ERCP or EUS for tissue diagnosis of biliary strictures? A prospective comparative study. Gastrointest Endosc. 2004;60:390–396.PubMedCrossRef
16.
Tellez-Avila FI, Bernal-Mendez AR, Guerrero-Vazquez CG, Martinez-Lozano JA, Ramirez-Luna MA. Diagnostic yield of EUS-guided tissue acquisition as a first-line approach in patients with suspected hilar cholangiocarcinoma. Am J Gastroenterol. 2014;109:1294–1296.PubMedCrossRef
17.
Sadeghi A, Mohamadnejad M, Islami F et al. Diagnostic yield of EUS-guided FNA for malignant biliary stricture: a systematic review and meta-analysis. Gastrointest Endosc. 2016;83:290-298 e291.PubMedCrossRef
18.
De Moura DTH, Moura EGH, Bernardo WM et al. Endoscopic retrograde cholangiopancreatography versus endoscopic ultrasound for tissue diagnosis of malignant biliary stricture: systematic review and meta-analysis. Endosc Ultrasound. 2018;7:10–19.PubMedCrossRef
19.
de Moura DTH, Ryou M, de Moura EGH, Ribeiro IB, Bernardo WM, Thompson CC. Endoscopic ultrasound-guided fine needle aspiration and endoscopic retrograde cholangiopancreatography-based tissue sampling in suspected malignant biliary strictures: a meta-analysis of same-session procedures. Clin Endosc. 2020;53:417–428.PubMedCrossRef
20.
21.
Singh A, Siddiqui UD. The role of endoscopy in the diagnosis and management of cholangiocarcinoma. J Clin Gastroenterol. 2015;49:725–737.PubMedCrossRef
22.
Rhee H, Park MS. The role of imaging in current treatment strategies for pancreatic adenocarcinoma. Korean J Radiol. 2021;22:23–40.
23.
Shamseer L, Moher D, Clarke M et al. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015: elaboration and explanation. BMJ. 2015;350:g7647.PubMedCrossRef
24.
Stroup DF, Berlin JA, Morton SC et al. Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis Of Observational Studies in Epidemiology (MOOSE) group. JAMA. 2000;283:2008–2012.PubMedCrossRef
25.
Stang A. Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses. Eur J Epidemiol. 2010;25:603–605.PubMedCrossRef
26.
27.
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;42:565–572.PubMedCrossRef
28.
Pugliese V, Conio M, Nicolo G, Saccomanno S, Gatteschi B. Endoscopic retrograde forceps biopsy and brush cytology of biliary strictures: a prospective study. Gastrointest Endosc. 1995;42:520–526.PubMedCrossRef
29.
Sugiyama M, Atomi Y, Wada N, Kuroda A, Muto T. Endoscopic transpapillary bile duct biopsy without sphincterotomy for diagnosing biliary strictures: a prospective comparative study with bile and brush cytology. Am J Gastroenterol. 1996;91:465–467.PubMed
30.
31.
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;32:363–368.PubMedCrossRef
32.
Glasbrenner B, Ardan M, Boeck W, Preclik G, Moller P, Adler G. Prospective evaluation of brush cytology of biliary strictures during endoscopic retrograde cholangiopancreatography. Endoscopy. 1999;31:712–717.PubMedCrossRef
33.
Vandervoort J, Soetikno RM, Montes H et al. Accuracy and complication rate of brush cytology from bile duct versus pancreatic duct. Gastrointest Endosc. 1999;49:322–327.PubMedCrossRef
34.
Jailwala J, Fogel EL, Sherman S et al. Triple-tissue sampling at ERCP in malignant biliary obstruction. Gastrointest Endosc. 2000;51:383–390.PubMedCrossRef
35.
Macken E, Drijkoningen M, Van Aken E, Van Steenbergen W. Brush cytology of ductal strictures during ERCP. Acta Gastroenterol Belg. 2000;63:254–259.PubMed
36.
Stewart CJ, Mills PR, Carter R et al. Brush cytology in the assessment of pancreatico-biliary strictures: a review of 406 cases. J Clin Pathol. 2001;54:449–455.PubMedPubMedCentralCrossRef
37.
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;58:176–182.PubMedCrossRef
38.
Byrne MF, Gerke H, Mitchell RM et al. Yield of endoscopic ultrasound-guided fine-needle aspiration of bile duct lesions. Endoscopy. 2004;36:715–719.PubMedCrossRef
39.
Eloubeidi MA, Chen VK, Jhala NC et al. Endoscopic ultrasound-guided fine needle aspiration biopsy of suspected cholangiocarcinoma. Clin Gastroenterol Hepatol. 2004;2:209–213.PubMedCrossRef
40.
Fritscher-Ravens A, Broering DC, Knoefel WT et al. EUS-guided fine-needle aspiration of suspected hilar cholangiocarcinoma in potentially operable patients with negative brush cytology. Am J Gastroenterol. 2004;99:45–51.PubMedCrossRef
41.
Khalid A, Pal R, Sasatomi E et al. Use of microsatellite marker loss of heterozygosity in accurate diagnosis of pancreaticobiliary malignancy from brush cytology samples. Gut. 2004;53:1860–1865.PubMedPubMedCentralCrossRef
42.
DeWitt J, Misra VL, Leblanc JK, McHenry L, Sherman S. EUS-guided FNA of proximal biliary strictures after negative ERCP brush cytology results. Gastrointest Endosc. 2006;64:325–333.PubMedCrossRef
43.
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;63:71–77.PubMedCrossRef
44.
Meara RS, Jhala D, Eloubeidi MA et al. Endoscopic ultrasound-guided FNA biopsy of bile duct and gallbladder: analysis of 53 cases. Cytopathology. 2006;17:42–49.PubMedCrossRef
45.
Ornellas LC, Santos Gda C, Nakao FS, Ferrari AP. Comparison between endoscopic brush cytology performed before and after biliary stricture dilation for cancer detection. Arq Gastroenterol. 2006;43:20–23.PubMedCrossRef
46.
Kitajima Y, Ohara H, Nakazawa T et al. Usefulness of transpapillary bile duct brushing cytology and forceps biopsy for improved diagnosis in patients with biliary strictures. J Gastroenterol Hepatol. 2007;22:1615–1620.PubMedCrossRef
47.
Dumonceau JM, Macias Gomez C, Casco C et al. Grasp or brush for biliary sampling at endoscopic retrograde cholangiography? A blinded randomized controlled trial. Am J Gastroenterol. 2008;103:333–340.PubMedCrossRef
48.
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;14:1097–1101.PubMedPubMedCentralCrossRef
49.
Kim YS, Kim HG, Han J et al. The significance of p53 and K-ras immunocytochemical staining in the diagnosis of malignant biliary obstruction by brush cytology during ERCP. Gut Liver. 2010;4:219–225.PubMedPubMedCentralCrossRef
50.
Kawada N, Uehara H, Katayama K et al. Combined brush cytology and stent placement in a single session for presumed malignant biliary stricture. J Gastroenterol Hepatol. 2011;26:1247–1251.PubMedCrossRef
51.
Mohamadnejad M, DeWitt JM, Sherman S et al. Role of EUS for preoperative evaluation of cholangiocarcinoma: a large single-center experience. Gastrointest Endosc. 2011;73:71–78.PubMedCrossRef
52.
Mohammad Alizadeh AH, Mousavi M, Salehi B et al. Biliary brush cytology in the assessment of biliary strictures at a tertiary center in Iran. Asian Pac J Cancer Prev. 2011;12:2793–2796.PubMed
53.
Nayar MK, Manas DM, Wadehra V, Oppong KE. Role of EUS/EUS-guided FNA in the management of proximal biliary strictures. Hepatogastroenterology. 2011;58:1862–1865.PubMed
54.
Ohshima Y, Yasuda I, Kawakami H et al. EUS-FNA for suspected malignant biliary strictures after negative endoscopic transpapillary brush cytology and forceps biopsy. J Gastroenterol. 2011;46:921–928.PubMedCrossRef
55.
Wright ER, Bakis G, Srinivasan R et al. Intraprocedural tissue diagnosis during ERCP employing a new cytology preparation of forceps biopsy (Smash protocol). Am J Gastroenterol. 2011;106:294–299.PubMedCrossRef
56.
Hartman DJ, Slivka A, Giusto DA, Krasinskas AM. Tissue yield and diagnostic efficacy of fluoroscopic and cholangioscopic techniques to assess indeterminate biliary strictures. Clin Gastroenterol Hepatol. 2012;10:1042–1046.PubMedCrossRef
57.
Kawashima H, Itoh A, Ohno E, Goto H, Hirooka Y. Transpapillary biliary forceps biopsy to distinguish benign biliary stricture from malignancy: how many tissue samples should be obtained? Dig Endosc. 2012;24:22–27.PubMedCrossRef
58.
Krishna N, Tummala P, Labundy J, Agarwal B. EUS guided fine needle aspiration is useful in diagnostic evaluation of indeterminate proximal biliary strictures. Open J. Gastroenterol. 2012;2:33–39.CrossRef
59.
Nischalke HD, Schmitz V, Luda C et al. Detection of IGF2BP3, HOXB7, and NEK2 mRNA expression in brush cytology specimens as a new diagnostic tool in patients with biliary strictures. PLoS One. 2012;7:e42141.PubMedPubMedCentralCrossRef
60.
Lee SJ, Lee YS, Lee MG, Lee SH, Shin E, Hwang JH. Triple-tissue sampling during endoscopic retrograde cholangiopancreatography increases the overall diagnostic sensitivity for cholangiocarcinoma. Gut Liver. 2014;8:669–673.PubMedPubMedCentralCrossRef
61.
Nishikawa T, Tsuyuguchi T, Sakai Y et al. Factors affecting the accuracy of endoscopic transpapillary sampling methods for bile duct cancer. Dig Endosc. 2014;26:276–281.PubMedCrossRef
62.
Shieh FK, Luong-Player A, Khara HS et al. Improved endoscopic retrograde cholangiopancreatography brush increases diagnostic yield of malignant biliary strictures. World J Gastrointest Endosc. 2014;6:312–317.PubMedPubMedCentralCrossRef
63.
Wakasa T, Inayama K, Honda T, Shintaku M, Okabe Y, Kakudo K. Brushing cytology of the biliary tract: bile juice from the ERCP sheath tube provides cell-rich smear samples. Acta Cytol. 2014;58:398–405.PubMedCrossRef
64.
Weilert F, Bhat YM, Binmoeller KF et al. EUS-FNA is superior to ERCP-based tissue sampling in suspected malignant biliary obstruction: results of a prospective, single-blind, comparative study. Gastrointest Endosc. 2014;80:97–104.PubMedCrossRef
65.
Boldorini R, Paganotti A, Andorno S et al. A multistep cytological approach for patients with jaundice and biliary strictures of indeterminate origin. J Clin Pathol. 2015;68:283–287.PubMedCrossRef
66.
Huang P, Zhang H, Zhang XF, Zhang X, Lyu W, Fan Z. Evaluation of intraductal ultrasonography, endoscopic brush cytology and K-ras, P53 gene mutation in the early diagnosis of malignant bile duct stricture. Chin Med J (Engl). 2015;128:1887–1892.PubMedPubMedCentralCrossRef
67.
Nanda A, Brown JM, Berger SH et al. Triple modality testing by endoscopic retrograde cholangiopancreatography for the diagnosis of cholangiocarcinoma. Therap Adv Gastroenterol. 2015;8:56–65.PubMedPubMedCentralCrossRef
68.
Sugimoto S, Matsubayashi H, Kimura H et al. Diagnosis of bile duct cancer by bile cytology: usefulness of post-brushing biliary lavage fluid. Endosc Int Open. 2015;3:E323-328.PubMedPubMedCentralCrossRef
69.
Chen WM, Wei KL, Chen YS et al. Transpapillary biliary biopsy for malignant biliary strictures: comparison between cholangiocarcinoma and pancreatic cancer. World J Surg Oncol. 2016;14:140.PubMedPubMedCentralCrossRef
70.
Naitoh I, Nakazawa T, Kato A et al. Predictive factors for positive diagnosis of malignant biliary strictures by transpapillary brush cytology and forceps biopsy. J Dig Dis. 2016;17:44–51.PubMedCrossRef
71.
Onda S, Ogura T, Kurisu Y et al. EUS-guided FNA for biliary disease as first-line modality to obtain histological evidence. Therap Adv Gastroenterol. 2016;9:302–312.PubMedPubMedCentralCrossRef
72.
Walter D, Peveling-Oberhag J, Schulze F et al. Intraductal biopsies in indeterminate biliary stricture: evaluation of histopathological criteria in fluoroscopy- vs. cholangioscopy guided technique. Dig Liver Dis. 2016;48:765–770.PubMedCrossRef
73.
Lee YN, Moon JH, Choi HJ et al. Diagnostic approach using ERCP-guided transpapillary forceps biopsy or EUS-guided fine-needle aspiration biopsy according to the nature of stricture segment for patients with suspected malignant biliary stricture. Cancer Med. 2017;6:582–590.PubMedPubMedCentralCrossRef
74.
Costa M, Canena J, Mascarenhas-Lemos L et al. Outcomes of different methods for analysis of biliary brush cytology and of factors associated with positive diagnosis in an age-dependent retrospective review. GE Port J Gastroenterol. 2018;26:5–13.PubMedPubMedCentralCrossRef
75.
Inoue T, Kitano R, Kobayashi Y et al. Assessing the diagnostic yield of controllable biopsy-forceps for biliary strictures. Scand J Gastroenterol. 2018;53:598–603.PubMedCrossRef
76.
Kato A, Naitoh I, Miyabe K et al. Differential diagnosis of cholangiocarcinoma and IgG4-related sclerosing cholangitis by fluorescence in situ hybridization using transpapillary forceps biopsy specimens. J Hepatobiliary Pancreat Sci. 2018;25:188–194.PubMedCrossRef
77.
Liew ZH, Loh TJ, Lim TKH et al. Role of fluorescence in situ hybridization in diagnosing cholangiocarcinoma in indeterminate biliary strictures. J Gastroenterol Hepatol. 2018;33:315–319.PubMedCrossRef
78.
Moura DTH, de Moura EGH, Matuguma SE et al. EUS-FNA versus ERCP for tissue diagnosis of suspect malignant biliary strictures: a prospective comparative study. Endosc Int Open. 2018;6:E769–E777.PubMedPubMedCentralCrossRef
79.
Ren YC, Huang CL, Chen SM, Zhao QY, Wan XJ, Li BW. Dilation catheter-guided mini-forceps biopsy improves the diagnostic accuracy of malignant biliary strictures. Endoscopy. 2018;50:809–812.PubMedCrossRef
80.
Kobayashi M, Ryozawa S, Araki R et al. Investigation of factors affecting the sensitivity of bile duct brush cytology. Intern Med. 2019;58:329–335.PubMedCrossRef
81.
Nakahara K, Michikawa Y, Morita R et al. Diagnostic Ability of Endoscopic Bile Cytology Using a Newly Designed Biliary Scraper for Biliary Strictures. Dig Dis Sci. 2019;64:241–248.PubMedCrossRef
82.
Onoyama T, Matsumoto K, Takeda Y et al. Endoscopic ultrasonography-guided fine needle aspiration for extrahepatic cholangiocarcinoma: a safe tissue sampling modality. J Clin Med. 2019;8:417.
83.
Yeo SJ, Cho CM, Jung MK, Seo AN, Bae HI. 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. Korean J Gastroenterol. 2019;73:213–218.PubMedCrossRef
84.
Chang HY, Liu B, Wang YZ et al. Percutaneous transhepatic cholangiography versus endoscopic retrograde cholangiography for the pathological diagnosis of suspected malignant bile duct strictures. Medicine (Baltimore). 2020;99:e19545.PubMedPubMedCentralCrossRef
85.
Chapman MH, Tidswell R, Dooley JS et al. Whole genome RNA expression profiling of endoscopic biliary brushings provides data suitable for biomarker discovery in cholangiocarcinoma. J Hepatol. 2012;56:877–885.PubMedCrossRef
86.
Jang SI, Kwon NH, Lim BJ et al. New staining method using methionyl-tRNA synthetase 1 antibody for brushing cytology of bile duct cancer. Gastrointest Endosc. 2020;92:310-319 e316.PubMedCrossRef
87.
Kipp BR, Fritcher EG, Clayton AC et al. Comparison of KRAS mutation analysis and FISH for detecting pancreatobiliary tract cancer in cytology specimens collected during endoscopic retrograde cholangiopancreatography. J Mol Diagn. 2010;12:780–786.PubMedPubMedCentralCrossRef
88.
Andresen K, Boberg KM, Vedeld HM et al. Four DNA methylation biomarkers in biliary brush samples accurately identify the presence of cholangiocarcinoma. Hepatology. 2015;61:1651–1659.PubMedCrossRef
89.
Lee JH, Salem R, Aslanian H, Chacho M, Topazian M. Endoscopic ultrasound and fine-needle aspiration of unexplained bile duct strictures. Am J Gastroenterol. 2004;99:1069–1073.PubMedCrossRef
90.
Malikowski T, Levy MJ, Gleeson FC et al. Endoscopic ultrasound/fine needle aspiration is effective for lymph node staging in patients with cholangiocarcinoma. Hepatology. 2020;72:940–948.
91.
Khashab MA, Fockens P, Al-Haddad MA. Utility of EUS in patients with indeterminate biliary strictures and suspected extrahepatic cholangiocarcinoma (with videos). Gastrointest Endosc. 2012;76:1024–1033.PubMedCrossRef
92.
Heimbach JK, Sanchez W, Rosen CB, Gores GJ. Trans-peritoneal fine needle aspiration biopsy of hilar cholangiocarcinoma is associated with disease dissemination. HPB (Oxford). 2011;13:356–360.PubMedPubMedCentralCrossRef
93.
El Chafic AH, Dewitt J, Leblanc JK et al. Impact of preoperative endoscopic ultrasound-guided fine needle aspiration on postoperative recurrence and survival in cholangiocarcinoma patients. Endoscopy. 2013;45:883–889.PubMedCrossRef
Metadata
Title
Brush Cytology, Forceps Biopsy, or Endoscopic Ultrasound-Guided Sampling for Diagnosis of Bile Duct Cancer: A Meta-Analysis
Authors
Seung Bae Yoon
Sung-Hoon Moon
Sung Woo Ko
Hyun Lim
Ho Suk Kang
Jong Hyeok Kim
Publication date
14-07-2021
Publisher
Springer US
Published in
Digestive Diseases and Sciences / Issue 7/2022
Print ISSN: 0163-2116
Electronic ISSN: 1573-2568
DOI
https://doi.org/10.1007/s10620-021-07138-4

Other articles of this Issue 7/2022

Digestive Diseases and Sciences 7/2022 Go to the issue

Original Article

Delayed Endoscopic Management of Esophageal Sharp-Pointed Food Impaction: An Analysis of 829 Cases in China

Correction

Correction to: Increased Fecal Bile Acid Excretion in a Significant Subset of Patients with Other Inflammatory Diarrheal Diseases

DDS Citation Classics

The GI Effects of GLP-1 – The Genesis of Longstanding Progress

Original Article

Predictive Modeling of Colonoscopic Findings in a Fecal Immunochemical Test-Based Colorectal Cancer Screening Program

Original Article

Lactated Ringers Does Not Reduce SIRS in Acute Pancreatitis Compared to Normal Saline: An Updated Meta-Analysis

Original Article

Endoscopic Management of Ampullary Adenomas in Familial Adenomatous Polyposis Syndrome: A Systematic Review with Pooled Analysis

ACC 2024 Congress Coverage

Heart Failure Video

Year in Review: Heart failure and cardiomyopathies

Watch now

Watch this official video from ACC.24. Dr. Biykem Bozkurt discuss last year's major advances in heart failure and cardiomyopathies.

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

16-04-2024 Type 2 Diabetes News

Incentivised to exercise

11-04-2024 Lifestyle Modifications News

New intervention for STEMI-related cardiogenic shock

10-04-2024 Myocardial Infarction News

» View more highlights on the ACC 2024 congress hub page

Image Credits