Advertisement
Research Article|Articles in Press

Innovative method for the diagnosis of bile duct lesions using a novel tapered-tip sheath system to facilitate biliary biopsies

Published:February 10, 2023DOI:https://doi.org/10.1016/j.gie.2023.02.005
      This paper is only available as a PDF. To read, Please Download here.

      ABSTRACT

      Background and Aims

      Pathological evaluation of bile duct lesions is crucial for definitive diagnosis and therapeutic strategy determination; however, it is limited by several challenges. Here, we evaluated the impact of a novel tapered-tip sheath system on biliary stricture diagnosis.

      Methods

      This observational study evaluated 47 consecutive patients who underwent transpapillary biliary stricture biopsy using the novel tapered-tip sheath system from July 2020 to March 2022 and compared with 51 historical controls undergoing conventional biopsies. Technical success rate, total biopsy time, number of biopsy specimens, adequate tissue sampling rate, adverse events, and diagnostic performance for biliary strictures were assessed.

      Results

      The technical success rate was favorable in both groups, showing no significant difference (97.9% [46/47] vs. 88.2% [45/51]; p=0.114). However, the total biopsy time was significantly shorter in the novel system group (3.7 vs. 7.7 min; p<0.001). The number of biopsy specimens did not differ between the groups; however, the novel system group had significantly more cases in which three or more tissues could be obtained (71.7% [33/46] vs. 51.1% [23/45]; p=0.043), a higher adequate tissue sampling rate (88.2% vs. 66.4%; p<0.001), and fewer adverse events (6.4% vs 21.6%; p=0.043). While the diagnostic specificity of both groups was 100%, the novel system group had significantly higher diagnostic sensitivity and accuracy (82.1% vs. 50%; p=0.004 and 84.8% vs. 55.5%; p=0.005, respectively).

      Conclusion

      The novel tapered-tip sheath system is a promising tool for biliary stricture diagnosis.

      KEY WORDS

      Acronyms and abbreviations:

      ERCP (Endoscopic retrograde cholangiopancreatography), POCS (Peroral cholangioscopy), EST (Endoscopic sphincterotomy), PEP (Post-endoscopic retrograde cholangiopancreatography pancreatitis)
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Gastrointestinal Endoscopy
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect