| International Session（Workshop）1(JGES・JSGE・JSGS・JSGCS) |
| Sat. November 23rd 9:30 - 12:00 Room 11: Portopia Hotel South Wing Topaz |
Cholangioscopy- versus fluoroscopy-guided transpapillary mapping biopsy for preoperative evaluation of extrahepatic cholangiocarcinoma: a prospective crossover study
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| Takahisa Ogawa1, Yoshihide Kanno1, Kei Ito1 | |||
| 1Department of Gastroenterology, Sendai City Medical Center | |||
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| Background: Transpapillary mapping biopsy (TMB) using two techniques such as fluoroscopy-guided technique (FGT) and cholangioscopy-guided one (CGT) is performed for preoperative evaluation of extrahepatic cholangiocarcinoma. Usefullness of CGT using a peroral digital cholangioscope (SpyGlass DS) remains controversial. Methods: Between September 2016 and October 2018, we conducted a prospective, crossover study to compare CGT with FGT for preoperative evaluation of extrahepatic cholangiocarcinoma. A block randomization was used to determine the first technique to be used. The sites of TMB were determined with surgeons on the basis of the resection line of a possible surgical procedure. TMB was attempted at least twice from same site. The primary outcome was the overall success rate of TMB. Successful TMB was defined as acquisition of specimens, including epithelium, sufficient for diagnosing malignancy. Results: Twenty-eight patients with extrahepatic cholangiocarcinoma were enrolled in this study. TMB with each technique were attempted from total of 118 sites. The rate of insufficient specimens was 31% (77/248) with CGT and 15% (25/172) with FGT (P < 0.001). Overall success rate of TMB with CGT and FGT were 78% (92/118) and 64% (76/118), respectively (P = 0.031). Conclusions: The overall success rate of TMB with CGT was significantly higher than that with FGT. Several biopsy from the same site are recommended with CGT due to its relatively higher rate of insufficient specimens. |
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Index Term 1: transpapillary mapping biopsy Index Term 2: preoperative evaluation of extrahepatic cholangiocarcinoma |
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