Increasing the Yield: When More Is Better
- PMID: 35287142
- DOI: 10.14309/ajg.0000000000001724
Increasing the Yield: When More Is Better
Abstract
Indeterminate biliary strictures pose a diagnostic challenge, and current approaches in the evaluation of such strictures lack diagnostic sensitivity. The most common method of tissue acquisition remains endoscopic retrograde cholangiopancreatography (ERCP) with brush cytology, however, little is known about optimal brush technique. In this paper by Wang et al., the authors compare the diagnostic sensitivity of brush cytology for 10, 20, and 30 passes in patients with malignant biliary strictures. The authors found an increase in sensitivity with an increasing number of passes, without an associated increase in adverse events. This well-designed study offers a simple and safe intervention which can increase the diagnostic sensitivity of ERCP-based brushing without requiring significant time, expense, or additional expertise.
Copyright © 2022 by The American College of Gastroenterology.
Comment on
-
More Endoscopy-Based Brushing Passes Improve the Detection of Malignant Biliary Strictures: A Multicenter Randomized Controlled Trial.Am J Gastroenterol. 2022 May 1;117(5):733-739. doi: 10.14309/ajg.0000000000001666. Epub 2022 Feb 2. Am J Gastroenterol. 2022. PMID: 35108222 Clinical Trial.
References
-
- Bowlus CL, Olson KA, Gershwin ME. Evaluation of indeterminate biliary strictures. Nat Rev Gastroenterol Hepatol 2016;13:28–37.
-
- Huynh R, Owers C, Pinto C, et al. Endoscopic evaluation of biliary strictures: Current and emerging techniques. Clin Endosc 2021;54(6):825–32.
-
- Gerhards MF, Vos P, van Gulik TM, et al. Incidence of benign lesions in patients resected for suspicious hilar obstruction. Br J Surg 2001;88(1):48–51.
-
- Korc P, Sherman S. ERCP tissue sampling. Gastrointest Endosc 2016;84:557–71.
-
- Navaneethan U, Njei B, Lourdusamy V, et al. Comparative effectiveness of biliary brush cytology and intraductal biopsy for detection of malignant biliary strictures: A systematic review and meta-analysis. Gastrointest Endosc 2015;81(1):168–76.
Publication types
MeSH terms
LinkOut - more resources
Full Text Sources
Medical