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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
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Article info
Publication history
Accepted:
February 6,
2023
Received in revised form:
January 26,
2023
Received:
August 30,
2022
Publication stage
In Press Journal Pre-ProofFootnotes
CONFLICT OF INTEREST DISCLOSURE
The authors declare that there is no conflict of interests.
AUTHORS’ CONTRIBUTIONS
All authors have contributed to and agreed on the content of the manuscript. TM and NU designed the study; TM, NU, HO, MS, TM, TK, HY, MY, KT, EH, and YK performed the research and collected the data; TM, NU, and HY analyzed the data and drafted the manuscript; TM, NU, and HS reviewed the manuscript.
Identification
Copyright
© 2023 by the American Society for Gastrointestinal Endoscopy
