Wirsing Lukas, Linzenbold Walter, Jaeger Simon U, Stahl Phillip, Ott German, Leibold Tobias, Enderle Markus, Albert Jörg, Peveling-Oberhag Jan
Department of Gastroenterology, Hepatology and Endocrinology, Robert-Bosch-Hospital, Stuttgart, Germany.
ERBE Elektromedizin GmbH, Tuebingen, Germany.
Endosc Int Open. 2022 Jun 10;10(6):E809-E814. doi: 10.1055/a-1797-8966. eCollection 2022 Jun.
Indeterminate biliary strictures represent a major challenge in clinical diagnostics. Diagnostic yield of radiological, endoscopic imaging and histopathological diagnosis is insufficient. The cryobiopsy technique is a new method for tissue extraction already used in different clinical settings. The aim of this ex vivo clinical study was to investigate feasibility and tissue quality of cryobiopsy in the bile duct. We included 14 patients who underwent pancreaticoduodenectomy. Bile duct samples were taken with either a new prototype cryoprobe or one of two forceps types. Results were analyzed for general feasibility, specimen size, histological assessability as well as representativity of retrieved tissue. Feasibility of cholangioscopic forceps was poor compared to gastric biopsy forceps or cryobiopsy. Significantly larger tissue samples were obtained with cryobiopsy (5.6 ± 4.5 mm ) compared to gastric biopsy forceps (3.3 ± 5.1 mm , = 0.006). Furthermore, cryobiopsy was superior in histological assessment quality ( = 0.02) and concerning representativity ( = 0.03). Cryobiopsy in the bile duct is feasible and the quality of the obtained tissue is high. Further investigation of bile duct cryobiopsy in vivo is warranted.
不确定的胆管狭窄是临床诊断中的一项重大挑战。放射学、内镜成像和组织病理学诊断的诊断率不足。冷冻活检技术是一种已在不同临床环境中使用的新型组织提取方法。这项体外临床研究的目的是调查胆管冷冻活检的可行性和组织质量。我们纳入了14例行胰十二指肠切除术的患者。使用新型原型冷冻探头或两种钳型之一采集胆管样本。对结果进行了一般可行性、标本大小、组织学可评估性以及所获取组织的代表性分析。与胃活检钳或冷冻活检相比，胆管镜钳的可行性较差。与胃活检钳（3.3±5.1mm，=0.006）相比，冷冻活检获得的组织样本明显更大（5.6±4.5mm）。此外，冷冻活检在组织学评估质量（=0.02）和代表性方面更具优势（=0.03）。胆管冷冻活检是可行的，所获组织质量较高。有必要对胆管冷冻活检进行进一步的体内研究。
