Comparison of tube-assisted mapping biopsy with digital single-operator peroral cholangioscopy for preoperative evaluation of biliary tract cancer

다국어 초록 (Multilingual Abstract)

Background/Aims: Digital single-operator cholangioscopy (DSOC)-guided mapping biopsy (DMB) and tube-assisted mapping biopsy(TMB) are two techniques used for preoperative evaluation of biliary tract cancer (BTC). However, data regarding the diagnostic performanceof these techniques are limited.
Methods: We retrospectively examined consecutive patients with BTC who underwent either technique at our institution between2018 and 2020. We evaluated the technical success rate, adequate tissue acquisition rate, and diagnostic performance of these techniquesfor the evaluation of lateral spread of BTC.
Results: A total of 54 patients were included in the study. The technical success rate of reaching the target sites was 95% for DMB and100% for TMB. The adequate tissue acquisition rate was 61% for DMB and 69% for TMB. The adequate tissue acquisition rate was low,especially for target sites beyond the secondary biliary radicles. The sensitivity of DMB alone was 39%, which improved to 65% whencombined with visual impression. Experts demonstrated a higher negative predictive value and diagnostic accuracy with respect toboth DSOC visual impression and DMB for the evaluation of lateral spread of BTC compared to trainees.
Conclusions: Adequate tissue acquisition rates were similar between the two techniques. Since DMB requires expertise, TMB may bean acceptable option when DSOC is unavailable or when DSOC expertise is limited.

참고문헌 (Reference)

1 Ogawa T, "Usefulness of cholangioscopic-guided mapping biopsy using SpyGlass DS for preoperative evaluation of extrahepatic cholangiocarcinoma : a pilot study" 6 : E199-E204, 2018

2 Hamada T, "The"zipline"technique for endoscopic transpapillary biliary biopsy" 52 : 236-237, 2020

3 Ito K, "The impact of MDCT and endoscopic transpapillary mapping biopsy to predict longitudinal spread of extrahepatic cholangiocarcinoma" 22 : 1528-1537, 2018

4 Manta R, "SpyGlass single-operator peroral cholangioscopy in the evaluation of indeterminate biliary lesions : a single-center, prospective, cohort study" 27 : 1569-1572, 2013

5 Navaneethan U, "Single-operator cholangioscopy and targeted biopsies in the diagnosis of indeterminate biliary strictures : a systematic review" 82 : 608-614, 2015

6 Mohamadnejad M, "Role of EUS for preoperative evaluation of cholangiocarcinoma : a large single-center experience" 73 : 71-78, 2011

7 Park HS, "Preoperative evaluation of bile duct cancer : MRI combined with MR cholangiopancreatography versus MDCT with direct cholangiography" 190 : 396-405, 2008

8 Nishikawa T, "Preoperative assessment of longitudinal extension of cholangiocarcinoma with peroral video-cholangioscopy : a prospective study" 26 : 450-457, 2014

9 Watadani T, "Preoperative assessment of hilar cholangiocarcinoma using multidetector-row CT : correlation with histopathological findings" 26 : 402-407, 2008

10 Osanai M, "Peroral video cholangioscopy to evaluate indeterminate bile duct lesions and preoperative mucosal cancerous extension : a prospective multicenter study" 45 : 635-642, 2013

11 Onoyama T, "Peroral cholangioscopy-guided forceps mapping biopsy for evaluation of the lateral extension of biliary tract cancer" 10 : 597-, 2021

12 Kanno Y, "Peroral cholangioscopy by SpyGlass DS versus CHF-B260 for evaluation of the lateral spread of extrahepatic cholangiocarcinoma" 6 : E1349-E1354, 2018

13 Kanda Y, "Investigation of the freely available easy-to-use software ‘EZR’ for medical statistics" 48 : 452-458, 2013

14 Noda Y, "Intraductal ultrasonography before biliary drainage and transpapillary biopsy in assessment of the longitudinal extent of bile duct cancer" 20 : 73-78, 2008

15 Jang S, "Efficacy of digital single-operator cholangioscopy and factors affecting its accuracy in the evaluation of indeterminate biliary stricture" 91 : 385-393, 2020

16 Gerges C, "Digital single-operator peroral cholangioscopy-guided biopsy sampling versus ERCP-guided brushing for indeterminate biliary strictures : a prospective, randomized, multicenter trial(with video)" 91 : 1105-1113, 2020

17 Kulpatcharapong S, "Diagnostic performance of different cholangioscopes in patients with biliary strictures : a systematic review" 52 : 174-185, 2020

18 Draganov PV, "Diagnostic accuracy of conventional and cholangioscopy-guided sampling of indeterminate biliary lesions at the time of ERCP : a prospective, long-term follow-up study" 75 : 347-353, 2012

19 Igami T, "Clinicopathologic study of cholangiocarcinoma with superficial spread" 249 : 296-302, 2009

20 Ogawa T, "Cholangioscopy-versus fluoroscopy-guided transpapillary mapping biopsy for preoperative evaluation of extrahepatic cholangiocarcinoma : a prospective randomized crossover study" 35 : 6481-6488, 2021

21 Onoyama T, "Adequate tissue acquisition rate of peroral cholangioscopy-guided forceps biopsy" 8 : 1073-, 2020

22 Okada H, "A novel technique for mapping biopsy of bile duct cancer" 53 : 647-651, 2021

23 Hijioka S, "A novel technique for endoscopic transpapillary"mapping biopsy specimens"of superficial intraductal spread of bile duct carcinoma(with videos)" 79 : 1020-1025, 2014

24 Ko SW, "A novel method of biopsy for indeterminate pancreaticobiliary strictures : tube-assisted biopsy" 52 : 589-594, 2020

25 Cotton PB, "A lexicon for endoscopic adverse events : report of an ASGE workshop" 71 : 446-454, 2010

26 Kawakami H, "A guidewire-assisted biopsy technique to assist advancement through a biliary stricture to perform selective mapping biopsy" 47 (47): E217-E218, 2015