Performance of bile aspiration plus brushing to diagnose malignant biliary strictures during endoscopic retrograde cholangiopancreatography
Background and study aims: Endobiliary brushing during endoscopic retrograde cholangiopancreatography (ERCP) is the main technique used to diagnose a malignant stricture, but has a poor sensitivity. This study evaluated the diagnostic performance of bile aspiration associated with biliary brushing d...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Georg Thieme Verlag KG
2016-08-01
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| Series: | Endoscopy International Open |
| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0042-108854 |
| _version_ | 1819209559808409600 |
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| author | Gael S. Roth Philippe Bichard Michele Fior-Gozlan Hubert Roth Jean Auroux Olivier Risse Christian Letoublon Marie Hélène Laverrière Ivan Bricault Vincent Leroy Thomas Decaens |
| author_facet | Gael S. Roth Philippe Bichard Michele Fior-Gozlan Hubert Roth Jean Auroux Olivier Risse Christian Letoublon Marie Hélène Laverrière Ivan Bricault Vincent Leroy Thomas Decaens |
| author_sort | Gael S. Roth |
| collection | DOAJ |
| description | Background and study aims: Endobiliary brushing during endoscopic retrograde cholangiopancreatography (ERCP) is the main technique used to diagnose a malignant stricture, but has a poor sensitivity. This study evaluated the diagnostic performance of bile aspiration associated with biliary brushing during ERCP to diagnose a malignant stricture, compared to brushing alone.
Patients and methods: Between January 2007 and December 2012, all consecutive patients undergoing ERCP to treat a biliary stricture were included. After a biliary sphincterotomy, 3 mL to 10 mL of bile was aspirated into the brush catheter and collected in a dry sterile tube before and after brushing (to yield three samples). Brushing was performed as commonly recommended.
Results: One hundred eleven patients (68 males, 43 females) were included; mean age 67 ± 15.4 years. A final diagnosis of malignant stricture was established in 51 patients, including 43 cholangiocarcinomas; 60 patients had benign strictures. Specificity (Sp) and positive predictive values were 100% for all samples. The diagnostic performance of the three-sample combination of bile aspiration + brushing + bile aspiration was significantly greater than brushing alone (P = 0.004): sensitivity (Se) = 84.3 % vs. Se = 66.7 %. The three-sample combination gave a negative predictive value of 88.2 %, and a diagnostic accuracy of 92.8 %. When suspicious results were added to malignant results as positive results, the three-sample combination gave Sp = 91.7 % and Se = 94.1 %.
Conclusions: In cases of biliary stricture, conducting bile aspiration before and after brushing significantly increased the ability to diagnose a malignant stricture with a sensitivity of 84.3 % (P = 0.004). |
| first_indexed | 2024-12-23T05:57:13Z |
| format | Article |
| id | doaj.art-9230bbd8d26642e1976fc9fd21a6467b |
| institution | Directory Open Access Journal |
| issn | 2364-3722 2196-9736 |
| language | English |
| last_indexed | 2024-12-23T05:57:13Z |
| publishDate | 2016-08-01 |
| publisher | Georg Thieme Verlag KG |
| record_format | Article |
| series | Endoscopy International Open |
| spelling | doaj.art-9230bbd8d26642e1976fc9fd21a6467b2022-12-21T17:57:47ZengGeorg Thieme Verlag KGEndoscopy International Open2364-37222196-97362016-08-010409E997E100310.1055/s-0042-108854Performance of bile aspiration plus brushing to diagnose malignant biliary strictures during endoscopic retrograde cholangiopancreatographyGael S. Roth0Philippe Bichard1Michele Fior-Gozlan2Hubert Roth3Jean Auroux4Olivier Risse5Christian Letoublon6Marie Hélène Laverrière7Ivan Bricault8Vincent Leroy9Thomas Decaens10Clinique Universitaire d’Hépato-gastroentérologie, Pôle Digidune, CHU Grenoble, AlpesClinique Universitaire d’Hépato-gastroentérologie, Pôle Digidune, CHU Grenoble, AlpesClinique Universitaire de Cytologie et Pathologie, Pôle Biologie et Pathologie, CHU Grenoble, AlpesPôle Recherche, CHU Grenoble, AlpesClinique Universitaire d’Hépato-gastroentérologie, Pôle Digidune, CHU Grenoble, AlpesClinique Universitaire de chirurgie digestive, Pôle Digidune, CHU Grenoble, AlpesINSERM U1209, Grenoble, FranceClinique Universitaire de Cytologie et Pathologie, Pôle Biologie et Pathologie, CHU Grenoble, AlpesFaculté de Médecine, Université Grenoble Alpes, Grenoble, FranceClinique Universitaire d’Hépato-gastroentérologie, Pôle Digidune, CHU Grenoble, AlpesClinique Universitaire d’Hépato-gastroentérologie, Pôle Digidune, CHU Grenoble, AlpesBackground and study aims: Endobiliary brushing during endoscopic retrograde cholangiopancreatography (ERCP) is the main technique used to diagnose a malignant stricture, but has a poor sensitivity. This study evaluated the diagnostic performance of bile aspiration associated with biliary brushing during ERCP to diagnose a malignant stricture, compared to brushing alone. Patients and methods: Between January 2007 and December 2012, all consecutive patients undergoing ERCP to treat a biliary stricture were included. After a biliary sphincterotomy, 3 mL to 10 mL of bile was aspirated into the brush catheter and collected in a dry sterile tube before and after brushing (to yield three samples). Brushing was performed as commonly recommended. Results: One hundred eleven patients (68 males, 43 females) were included; mean age 67 ± 15.4 years. A final diagnosis of malignant stricture was established in 51 patients, including 43 cholangiocarcinomas; 60 patients had benign strictures. Specificity (Sp) and positive predictive values were 100% for all samples. The diagnostic performance of the three-sample combination of bile aspiration + brushing + bile aspiration was significantly greater than brushing alone (P = 0.004): sensitivity (Se) = 84.3 % vs. Se = 66.7 %. The three-sample combination gave a negative predictive value of 88.2 %, and a diagnostic accuracy of 92.8 %. When suspicious results were added to malignant results as positive results, the three-sample combination gave Sp = 91.7 % and Se = 94.1 %. Conclusions: In cases of biliary stricture, conducting bile aspiration before and after brushing significantly increased the ability to diagnose a malignant stricture with a sensitivity of 84.3 % (P = 0.004).http://www.thieme-connect.de/DOI/DOI?10.1055/s-0042-108854 |
| spellingShingle | Gael S. Roth Philippe Bichard Michele Fior-Gozlan Hubert Roth Jean Auroux Olivier Risse Christian Letoublon Marie Hélène Laverrière Ivan Bricault Vincent Leroy Thomas Decaens Performance of bile aspiration plus brushing to diagnose malignant biliary strictures during endoscopic retrograde cholangiopancreatography Endoscopy International Open |
| title | Performance of bile aspiration plus brushing to diagnose malignant biliary strictures during endoscopic retrograde cholangiopancreatography |
| title_full | Performance of bile aspiration plus brushing to diagnose malignant biliary strictures during endoscopic retrograde cholangiopancreatography |
| title_fullStr | Performance of bile aspiration plus brushing to diagnose malignant biliary strictures during endoscopic retrograde cholangiopancreatography |
| title_full_unstemmed | Performance of bile aspiration plus brushing to diagnose malignant biliary strictures during endoscopic retrograde cholangiopancreatography |
| title_short | Performance of bile aspiration plus brushing to diagnose malignant biliary strictures during endoscopic retrograde cholangiopancreatography |
| title_sort | performance of bile aspiration plus brushing to diagnose malignant biliary strictures during endoscopic retrograde cholangiopancreatography |
| url | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0042-108854 |
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