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KMID : 1188320160100040642
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Gut and Liver
2016 Volume.10 No. 4 p.642 ~ p.648
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The Wire-Grasping Method as a New Technique for Forceps Biopsy of Biliary Strictures: A Prospective Randomized Controlled Study of Effectiveness
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Yasunobu Yamashita
Kazuki Ueda
Yuki Kawaji
Takashi Tamura
Takeichi Yoshida
Hiroki Maeda
Takao Maekita
Mikitaka Iguchi
Hideyuki Tamai
Masao Ichinose
Jun Kato
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Abstract
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Background/Aims:Transpapillary forceps biopsy is an effective diagnostic technique in patients with biliary stricture. This prospective study aimed to determine the usefulness of the wire-grasping method as a new technique for forceps biopsy.
Methods:Consecutive patients with biliary stricture or irregularities of the bile duct wall were randomly allocated to either the direct or wire-grasping method group. In the wire-grasping method, forceps in the duodenum grasps a guide-wire placed into the bile duct beforehand, and then, the forceps are pushed through the papilla without endoscopic sphincterotomy. In the direct method, forceps are directly pushed into the bile duct alongside a guide-wire. The primary endpoint was the success rate of obtaining specimens suitable for adequate pathological examination.
Results:In total, 32 patients were enrolled, and 28 (14 in each group) were eligible for analysis. The success rate was significantly higher using the wire-grasping method than the direct method (100% vs 50%, p=0.016). Sensitivity and accuracy for the diagnosis of cancer were comparable in patients with the successful procurement of biopsy specimens between the two methods (91% vs 83% and 93% vs 86%, respectively).
Conclusions:The wire-grasping method is useful for diagnosing patients with biliary stricture or irregularities of the bile duct wall.
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KEYWORD
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Biliary tract, Endoscopic transpapillary biopsy, Biliary strictures, Surgical instruments, Sphincterotomy
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