Wu Zheng-Yang, Jiao De-Chao, Guo Fang-Fang, Zhang Dan-Dan, Ren Jian-Zhuang, Han Xin-Wei
Department of Interventional Radiology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Department of Pathology, Zhengzhou University People's Hospital & Henan Provincial People's Hospital, Zhengzhou, China.
Quant Imaging Med Surg. 2022 Jan;12(1):207-214. doi: 10.21037/qims-21-161.
The present study aimed to compare the clinical results and pathological diagnostic quality of percutaneous transhepatic cholangiobiopsy for biliary obstruction using biopsy forceps (BFs) of varying diameter.
A total of 57 patients with obstructive jaundice who underwent percutaneous transhepatic cholangiobiopsy and drainage with 1 of 2 BFs diameters (6.0-mm BFs, n=30; 4.5-mm BFs, n=27) between February 2018 and May 2019 were retrospectively assessed. BFs were compared in terms of their sample quality, diagnostic accuracy, sensitivity, specificity, number of passes, and complication rate.
All 57 patients underwent the procedure successfully and the technical success rate was 100%. The 6.0- and 4.5-mm BFs demonstrated a diagnostic accuracy of 80% (24/30) and 85% (23/27), respectively (P=0.733), and a sensitivity of 78% (22/28) and 86% (22/26), respectively (P=0.729). The specificity of both the 6.0- and 4.5-mm BFs was 100%. The complication rate was 10% (3/30) with the 6.0-mm BFs and 19% (5/27) with the 4.5-mm BFs (P=0.456). The mean number of biopsies was 2.9±0.6 with the 6.0-mm BFs compared with 3.6±1.0 with the 4.5-mm BFs (P<0.001). The 6.0-mm BFs provided a larger biopsy size and a less crushed specimen compared with the 4.5-mm BFs. The overall tissue scores were 5.2±0.8 with 6.0-mm BFs and 4.5±1.0 with 4.5-mm BFs (P=0.012).
There was no statistically significant difference in the clinical results between the 2 BFs in the context of percutaneous transhepatic cholangiobiopsy. Superior samples were obtained using the 6.0-mm BFs, with a fewer number of passes. The complication rate did not increase compared with the 4.5-mm BFs.
本研究旨在比较使用不同直径活检钳（BFs）进行经皮经肝胆管活检对胆道梗阻的临床结果和病理诊断质量。
回顾性评估2018年2月至2019年5月期间共57例接受经皮经肝胆管活检及引流的梗阻性黄疸患者，这些患者使用两种直径（6.0mm BFs，n = 30；4.5mm BFs，n = 27）中的一种BFs。比较了BFs在样本质量、诊断准确性、敏感性、特异性、穿刺次数和并发症发生率方面的差异。
所有57例患者均成功完成手术，技术成功率为100%。6.0mm和4.5mm BFs的诊断准确性分别为80%（24/30）和85%（23/27）（P = 0.733），敏感性分别为78%（22/28）和86%（22/26）（P = 0.729）。6.0mm和4.5mm BFs的特异性均为100%。6.0mm BFs的并发症发生率为10%（3/30），4.5mm BFs为19%（5/27）（P = 0.45）。6.0mm BFs的平均活检次数为2.9±0.6次，而4.5mm BFs为3.6±1.0次（P<0.001）。与4.5mm BFs相比, 6.0mm BFs获取的活检标本更大且挤压程度更小。6.0mm BFs的总体组织评分为5.2±0.8，4.5mm BFs为4.5±1.0（P = 0.012）。
在经皮经肝胆管活检中，两种BFs的临床结果无统计学显著差异。使用6.0mm BFs可获得更好的样本，穿刺次数更少。与4.5mm BFs相比，并发症发生率并未增加。
