Ko Sung Woo, Lee Sang Soo, So Hoonsub, Hwang Jun Seong, Song Tae Jun, Lee Sung Koo, Kim Myung-Hwan
Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Endoscopy. 2020 Jul;52(7):589-594. doi: 10.1055/a-1127-3265. Epub 2020 Mar 27.
Single-operator cholangioscopy (SOC) provides an accurate diagnosis of indeterminate pancreaticobiliary strictures. However, the procedure is expensive and can be performed using only limited accessories. Therefore, we devised a novel tube-assisted biopsy (TAB) technique and evaluated its feasibility, diagnostic yield, and safety for indeterminate pancreaticobiliary strictures.
The medical records of patients with indeterminate pancreaticobiliary strictures who underwent TAB between September 2018 and July 2019 were reviewed. We assessed the technical success rate, adverse event rate, sensitivity, specificity, and overall accuracy of TAB in differentiating malignant from benign lesions.
TABs were performed in 16 patients: 12 had biliary strictures; four had pancreatic strictures. The technical success rate was 93.7 % (15/16), and the sensitivity, specificity, and overall accuracy of TAB were 87.5 %, 100 %, and 93.7 %, respectively. No serious adverse events occurred either during or after the procedure in any of the patients.
TAB has an acceptable accuracy for the diagnosis of indeterminate pancreaticobiliary strictures and may represent a useful diagnostic method in patients where SOC cannot be implemented.
单操作者胆管镜检查（SOC）可对不明原因的胰胆管狭窄进行准确诊断。然而，该操作成本高昂，且仅能使用有限的附件。因此，我们设计了一种新型的导管辅助活检（TAB）技术，并评估了其对不明原因胰胆管狭窄的可行性、诊断率及安全性。
回顾性分析2018年9月至2019年7月期间接受TAB的不明原因胰胆管狭窄患者的病历。我们评估了TAB在鉴别恶性与良性病变方面的技术成功率、不良事件发生率、敏感性、特异性及总体准确性。
16例患者接受了TAB：12例为胆管狭窄；4例为胰腺狭窄。技术成功率为93.7%（15/16），TAB的敏感性、特异性及总体准确性分别为87.5%、100%及93.7%。所有患者在操作期间及操作后均未发生严重不良事件。
TAB对不明原因胰胆管狭窄的诊断具有可接受的准确性，对于无法实施SOC的患者可能是一种有用的诊断方法。
