Comparison of EUS and ERCP-guided tissue sampling in suspected biliary stricture.

<h4>Background</h4>Endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic ultrasound (EUS) are commonly used diagnostic modalities in biliary strictures. We compared the diagnostic yield of EUS and ERCP-based tissue sampling in intrinsic biliary strictures without extrinsic...

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Autores principales:	Hye Gyo Chung, Jong-In Chang, Kwang Hyuk Lee, Joo Kyung Park, Kyu Taek Lee, Jong Kyun Lee
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/e1191b1742e84761bb38d07e2515d316
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spelling	oai:doaj.org-article:e1191b1742e84761bb38d07e2515d3162021-12-02T20:16:43ZComparison of EUS and ERCP-guided tissue sampling in suspected biliary stricture.1932-620310.1371/journal.pone.0258887https://doaj.org/article/e1191b1742e84761bb38d07e2515d3162021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0258887https://doaj.org/toc/1932-6203<h4>Background</h4>Endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic ultrasound (EUS) are commonly used diagnostic modalities in biliary strictures. We compared the diagnostic yield of EUS and ERCP-based tissue sampling in intrinsic biliary strictures without extrinsic mass outside the bile duct.<h4>Methods</h4>A total of 85 patients who underwent ERCP and EUS for diagnosis of suspected biliary strictures confined to the bile duct were analyzed retrospectively at Samsung Medical Center, Seoul, Korea, between 2010 and 2018.<h4>Results</h4>Seventy-one patients were diagnosed with malignancy and 14 patients were diagnosed with benign strictures. EUS-based tissue sampling was more sensitive and accurate than ERCP-based tissue sampling (p = 0.038). The overall sensitivity and accuracy were 67.6% (95% confidence interval (CI) 56.1-77.3) and 72.9% (95% CI 62.7-81.2) for ERCP-based sampling, and 80.3% (95% CI 69.6-87.9) and 83.5% (95% CI 74.2-89.9) for EUS-based sampling, respectively. EUS-based sampling was superior to ERCP-based sampling in distal bile duct strictures (accuracy: 87.0% vs. 72.5%, p = 0.007), but not in perihilar strictures. In cases without intraductal mass, EUS-based tissue sampling was also superior to ERCP-based sampling (accuracy: 83.3% vs. 69.7%, p = 0.029), but not in cases with mass.<h4>Conclusion</h4>EUS-based tissue sampling was superior to ERCP-based method in intrinsic biliary stricture with no mass outside the bile duct, particularly in those without intraductal mass or those with strictures located in distal bile duct. Therefore, EUS-based sampling should be considered for making a pathological diagnosis of suspected distal bile duct strictures even in lesions without definite mass.Hye Gyo ChungJong-In ChangKwang Hyuk LeeJoo Kyung ParkKyu Taek LeeJong Kyun LeePublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 10, p e0258887 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Hye Gyo Chung Jong-In Chang Kwang Hyuk Lee Joo Kyung Park Kyu Taek Lee Jong Kyun Lee Comparison of EUS and ERCP-guided tissue sampling in suspected biliary stricture.
description	<h4>Background</h4>Endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic ultrasound (EUS) are commonly used diagnostic modalities in biliary strictures. We compared the diagnostic yield of EUS and ERCP-based tissue sampling in intrinsic biliary strictures without extrinsic mass outside the bile duct.<h4>Methods</h4>A total of 85 patients who underwent ERCP and EUS for diagnosis of suspected biliary strictures confined to the bile duct were analyzed retrospectively at Samsung Medical Center, Seoul, Korea, between 2010 and 2018.<h4>Results</h4>Seventy-one patients were diagnosed with malignancy and 14 patients were diagnosed with benign strictures. EUS-based tissue sampling was more sensitive and accurate than ERCP-based tissue sampling (p = 0.038). The overall sensitivity and accuracy were 67.6% (95% confidence interval (CI) 56.1-77.3) and 72.9% (95% CI 62.7-81.2) for ERCP-based sampling, and 80.3% (95% CI 69.6-87.9) and 83.5% (95% CI 74.2-89.9) for EUS-based sampling, respectively. EUS-based sampling was superior to ERCP-based sampling in distal bile duct strictures (accuracy: 87.0% vs. 72.5%, p = 0.007), but not in perihilar strictures. In cases without intraductal mass, EUS-based tissue sampling was also superior to ERCP-based sampling (accuracy: 83.3% vs. 69.7%, p = 0.029), but not in cases with mass.<h4>Conclusion</h4>EUS-based tissue sampling was superior to ERCP-based method in intrinsic biliary stricture with no mass outside the bile duct, particularly in those without intraductal mass or those with strictures located in distal bile duct. Therefore, EUS-based sampling should be considered for making a pathological diagnosis of suspected distal bile duct strictures even in lesions without definite mass.
format	article
author	Hye Gyo Chung Jong-In Chang Kwang Hyuk Lee Joo Kyung Park Kyu Taek Lee Jong Kyun Lee
author_facet	Hye Gyo Chung Jong-In Chang Kwang Hyuk Lee Joo Kyung Park Kyu Taek Lee Jong Kyun Lee
author_sort	Hye Gyo Chung
title	Comparison of EUS and ERCP-guided tissue sampling in suspected biliary stricture.
title_short	Comparison of EUS and ERCP-guided tissue sampling in suspected biliary stricture.
title_full	Comparison of EUS and ERCP-guided tissue sampling in suspected biliary stricture.
title_fullStr	Comparison of EUS and ERCP-guided tissue sampling in suspected biliary stricture.
title_full_unstemmed	Comparison of EUS and ERCP-guided tissue sampling in suspected biliary stricture.
title_sort	comparison of eus and ercp-guided tissue sampling in suspected biliary stricture.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/e1191b1742e84761bb38d07e2515d316
work_keys_str_mv	AT hyegyochung comparisonofeusandercpguidedtissuesamplinginsuspectedbiliarystricture AT jonginchang comparisonofeusandercpguidedtissuesamplinginsuspectedbiliarystricture AT kwanghyuklee comparisonofeusandercpguidedtissuesamplinginsuspectedbiliarystricture AT jookyungpark comparisonofeusandercpguidedtissuesamplinginsuspectedbiliarystricture AT kyutaeklee comparisonofeusandercpguidedtissuesamplinginsuspectedbiliarystricture AT jongkyunlee comparisonofeusandercpguidedtissuesamplinginsuspectedbiliarystricture
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Comparison of EUS and ERCP-guided tissue sampling in suspected biliary stricture.

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