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Hiroki Tanaka,Shimpei Matsusaki,Youichirou Baba,Yoshiaki Isono,Tomohiro Sase,Hiroshi Okano,Tomonori Saito,Katsumi Mukai,Tetsuya Murata,Hiroki Taoka 대한소화기내시경학회 2018 Clinical Endoscopy Vol.51 No.2
Background/Aims: It is sometimes difficult to distinguish between malignant and benign biliary strictures using imaging studiesalone, and pathological diagnosis is necessary. The aim of this study was to determine the usefulness of endoscopic transpapillary tissuesampling and factors predictive of diagnostic accuracy. Methods: From April 2008 to December 2014, 136 patients underwent endoscopic transpapillary tissue sampling for malignantbiliary strictures. The cytological and histological findings were reported as negative, suspicious, or positive. Suspicious and positivefindings were defined as pathologically positive. Results: The sensitivity was 65.0% for forceps biopsy, 49.5% for brush cytology, 46.2% for bile aspiration cytology, and 21.9% forendoscopic nasobiliary drainage cytology. The combination of these procedures improved the sensitivity (72.8%). Endoscopictranspapillary tissue sampling was more sensitive for lesions of biliary origin (91.4%) than for extrabiliary lesions (66.3%). In surgicalcases, the sensitivity for tumors with an infiltrative growth pattern (53.3%) was significantly lower than for a tumor with an expandingor intermediate growth pattern (87.5%). Conclusions: Combining procedures can improve diagnostic accuracy. It may be possible to predict the sensitivity of endoscopictranspapillary tissue sampling by evaluating the etiology and tumor growth pattern using preoperative imaging studies.