Percutaneous Endoluminal Forceps Biopsy in Cholangiocellular Carcinoma - A Perspective Approach to Timeliness of Diagnostic Confirmation Using Two Scenarios
| Authors | |
|---|---|
| Year of publication | 2019 |
| Type | Article in Periodical |
| Magazine / Source | Japanese Journal of Gastroenterology and Hepatology |
| MU Faculty or unit | |
| Citation | |
| Web | https://www.jjgastrohepto.org/pdf/JJGH-1012.pdf |
| Keywords | biliary intervention; endoluminal forceps biopsy; cholangiocellular carcinoma |
| Description | 1.1. Aim: To assess the benefits of performing endoluminal forceps biopsy during initial drainage compared to postponed biopsy using two patient management scenarios. 1.2. Methods: Since 2006, 101 consecutive patients with malignant biliary stenosis due to cholangiocellular carcinoma have been followed up. All patients underwent a percutaneous biliary drainage (PBD) procedure and endoluminal forceps biopsy to obtain histological verification of stenosis. The cumulative success rate, complication rate, time needed to obtain diagnosis, and procedural costs were studied in two scenarios. In the first scenario, 59 patients underwent percutaneous drainage first and after 1–40 (median 7) days, had a postponed biopsy using multi-use 7.5F biopsy forceps. In the second scenario, 42 patients underwent percutaneous drainage and successive biopsy in a single, combined procedure using 5.2F disposable biopsy forceps. 1.3. Results: Interventions with a single-procedure PBD biopsy were not associated with a higher rate of complications. The cumulative success rates of endoluminal biopsy in both scenarios were 81% and 76%, respectively. The average time needed to obtain a conclusive biopsy specimen from the time of initial drainage were 47 days and 10 days (p = 0.002). Patients undergoing endoluminal biopsy with the 5.2F forceps benefited from 2,1 fewer percutaneous interventions on average (p< 0.001) and procedural expenses per patient were on average 1.84 times lower (p< 0.001). 1.4. Conclusion: Percutaneous forceps biopsy is a safe procedure even when performed during initial drainage. Its success rate is comparable to that of the postponed biopsy procedure, meanwhile malignancy is determined significantly sooner and healthcare expenses are significantly lower. |
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