Department of Gastroenterology and Hepatology, Kyoto University Graduate School of Medicine, Kyoto, Japan.
Kitano Hospital, Tazuke Kofukai Medical Research Institute, Osaka, Japan.
J Gastroenterol Hepatol. 2022 Jul;37(7):1360-1366. doi: 10.1111/jgh.15866. Epub 2022 Apr 20.
Pathological evaluation is essential for the diagnosis of biliary tract diseases. However, existing evaluation methods have various challenges in terms of operability and diagnostic performance. The present study aimed to evaluate the feasibility, utility, and safety of a novel device delivery system for bile duct biopsy.
This study was conducted as a retrospective, descriptive analysis at a single center. Overall, 25 examinations in 14 consecutive patients who underwent transpapillary biopsies for biliary lesions using the novel device delivery system from July to November 2020 were reviewed. Number and time of biopsy, technical success rate, adequate tissue sampling rate, adverse events, and diagnostic performance of bile duct biopsies using the novel device were evaluated. Moreover, negative surgical margins were assessed in patients who underwent surgical resection after mapping biopsy.
The median number of biopsy samples was five (range: 2-13), with a median biopsy time of 11.6 min. The technical success rate was 100% (140/140), with an adequate sampling rate of 82.9% (116/140). These rates did not differ depending on the biopsy site or purpose. There were no serious adverse events related to the procedures. The diagnostic sensitivity, specificity, and accuracy of biliary stricture were 90%, 100%, and 92.3%, respectively. Negative surgical margins were confirmed in all patients undergoing surgical resection, including one patient with a surgical procedure changed based on the results of mapping biopsy.
The novel device delivery system has potentials in diagnosing biliary tract diseases and determining appropriate treatment strategies.
病理评估对于胆道疾病的诊断至关重要。然而,现有的评估方法在操作性和诊断性能方面存在各种挑战。本研究旨在评估一种新型胆管活检器械输送系统的可行性、实用性和安全性。
这是一项在一家中心进行的回顾性描述性分析。共有 14 例连续患者在 2020 年 7 月至 11 月期间使用新型器械输送系统行经乳头胆管活检,对 25 例检查进行了评估。评估了新型器械的活检次数和时间、技术成功率、充分组织取样率、不良事件以及胆管活检的诊断性能。此外,评估了在进行定位活检后接受手术切除的患者的阴性手术切缘。
活检样本中位数为 5 个(范围:2-13 个),活检中位数时间为 11.6 分钟。技术成功率为 100%(140/140),充分取样率为 82.9%(116/140)。这些成功率不受活检部位或目的的影响。无与该程序相关的严重不良事件。胆管狭窄的诊断灵敏度、特异度和准确度分别为 90%、100%和 92.3%。所有接受手术切除的患者均证实了阴性手术切缘,包括一名根据定位活检结果改变手术方式的患者。
新型胆管活检器械输送系统在诊断胆道疾病和确定适当的治疗策略方面具有潜力。