Endoscopic retrograde wire-guided cytology of malignant biliary strictures using a novel scraping brush.

BACKGROUND

Tissue sampling to differentiate benign from malignant pancreatobiliary strictures remains problematic despite the availability of several new sampling methods. A new device is described which attempts to correct some of the drawbacks.

METHODS

The device consists of a 10F dilator which has an attached pad of Velcro. The Velcro has semi-rigid, mushroom-shaped bristles. A cytologic sample is obtained by the abrasive action of the brush when it is passed through the stricture. Fifteen patients with obstructive jaundice underwent brushing of the bile duct using this device.

RESULTS

Cytologic samples obtained with this device were positive for malignancy in all 15 patients. Diagnostic confirmation was obtained by assessment of clinical course, radiologic findings, and during surgery.

CONCLUSION

Preliminary experience indicates that this new device enhances the yield of tissue sampling from malignant bile duct strictures.