SNFGE SNFGE
 
Thématique :
- Endoscopie/Imagerie
Originalité :
Très original
Solidité :
Intermédiaire
Doit faire évoluer notre pratique :
Dans certains cas
 
 
Nom du veilleur :
Docteur Vincent VALANTIN
Coup de coeur :
 
 
Endoscopy
  2018/08  
 
  2018 Aug;50(8):809-812.  
  doi: 10.1055/a-0630-0878.  
 
  Dilation catheter-guided mini-forceps biopsy improves the diagnostic accuracy of malignant biliary strictures.  
 
  Ren YC, Huang CL, Chen SM, Zhao QY, Wan XJ, Li BW  
  https://www.ncbi.nlm.nih.gov/pubmed/29966143  
 
 

Abstract

BACKGROUND:

 Tissue sampling for biliary stricture is important for differential diagnosis and further treatment. The aim of this study was to assess a novel dilation catheter-guided mini-forceps biopsy (DCMB) method in the diagnosis of malignant biliary strictures.

METHODS:

 42 patients with malignant biliary stricture who underwent both brush cytology and DCMB during endoscopic retrograde cholangiopancreatography between October 2014 and November 2015 were retrospectively included. During DCMB, the mini biopsy forceps was introduced into the biliary stricture through the dilation catheter, and then the position and direction of the forceps were adjusted to obtain tissue samples.

RESULTS:

 The positive rate of DCMB was significantly higher than that of brush cytology (81.0 % [34/42] vs. 38.1 % [16/42]; P < 0.001). No severe complications occurred; three patients (7.1 %) experienced mild procedure-related acute pancreatitis.

CONCLUSIONS:

 The novel DCMB technique was a practical, safe, efficient, and low-costing method for diagnosing malignant biliary stricture with a high accuracy rate.

 

 
Question posée
 
Évaluer une nouvelle technique de mini biopsie intra-choledocienne (DCMB) en le comparant au brossage cytologique standard.
 
Question posée
 
81% vs 38% (P<0,0001). Rendement trois fois supérieur. Pour des complications rares qui sont dues probablement plus à la dilatation qu’à la mini biopsie.
 
Commentaires

Efficacité nettement supérieure au brossage standard et coût nettement inférieur à l’utilisation d’un cholangioscope numérique pour mini biopsies ciblées. Attente d’une étude prospective comparant cette nouvelle technique à la technique nécessitant une cholangioscope.

 
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