The Korean Journal of Medicine

The Korean Association of Internal Medicine (대한내과학회)
권호 표지

Recent update of endoscopic diagnosis of hilar cholangiocarcinoma

간문부 담관암의 내시경적 진단의 최신 지견

  • Moon, Jong-Ho (Digestive Disease Center, Department of Internal Medicine, Soonchunhyang University College of Medicine)
  • 문종호 (순천향대학교 의과대학 내과학교실)
  • Published : 2010.12.01
⟨ Previous Next ⟩

Abstract

The diagnosis of hilar cholangiocarcinoma (CCA) is usually accomplished through a combination of imaging modalities and endoscopic examination including tissue sampling. Although high quality cross-sectional imagings provide evidences for hilar obstruction and a malignancy arising from the bile duct, a definitive diagnosis and staging often obtained through the use of endoscopic procedures. It can provide complementary information for accurate tumor extension and tissue acquisition for histologic confirmation. These informations are important in determining therapeutic options. However, despite the various available techniques, the diagnosis and accurate staging of hilar CCA is often still challenging. Newly developed adjunctive diagnostic endoscopic techniques including intraductal ultrasound and cholangioscopy improve the accuracy of endoscopic diagnosis of this lesion. Multiple endoscopic modalities can be tried to obtain accurate assessment of the tumor. Therefore, endoscopy will continue to occupy an important position in assessment of the hilar CCA.

Keywords

References

  1. Olnes MJ, Erlich R. A review and update on cholangiocarcinoma. Oncology 66:167-179, 2004 https://doi.org/10.1159/000077991
  2. Coelho-Prabhu N, Baron TH. Endoscopic retrograde cholangiopancreatography in the diagnosis and management of cholangiocarcinoma. Clin Liver Dis 14:333-348, 2010 https://doi.org/10.1016/j.cld.2010.03.011
  3. Blechacz BR, Gores GJ. Cholangiocarcinoma. Clin Liver Dis 12:131-150, ix, 2008 https://doi.org/10.1016/j.cld.2007.11.003
  4. Ito F, Cho CS, Rikkers LF, Weber SM. Hilar cholangiocarcinoma: current management. Ann Surg 250:210-218, 2009 https://doi.org/10.1097/SLA.0b013e3181afe0ab
  5. Blechacz B, Gores GJ. Cholangiocarcinoma: advances in pathogenesis, diagnosis, and treatment. Hepatology 48:308-321, 2008
  6. Brugge WR. Endoscopic techniques to diagnose and manage biliary tumors. J Clin Oncol 23:4561-4565, 2005 https://doi.org/10.1200/JCO.2005.19.729
  7. Weber A, Schmid RM, Prinz C. Diagnostic approaches for cholangiocarcinoma. World J Gastroenterol 14:4131-4136, 2008 https://doi.org/10.3748/wjg.14.4131
  8. Freeman ML, Sielaff TD. A modern approach to malignant hilar biliary obstruction. Rev Gastroenterol Disord 3:187-201, 2003
  9. Choi JY, Kim MJ, Lee JM, Kim KW, Lee JY, Han JK, Choi BI. Hilar cholangiocarcinoma: role of preoperative imaging with sonography, MDCT, MRI, and direct cholangiography. AJR Am J Roentgenol 191:1448-1457, 2008 https://doi.org/10.2214/AJR.07.3992
  10. Rauws EA, Kloek JJ, Gouma DJ, Van Gulik TM. Staging of cholangiocarcinoma: the role of endoscopy. HPB (Oxford) 10:110-112, 2008 https://doi.org/10.1080/13651820801992591
  11. Aljiffry M, Walsh MJ, Molinari M. Advances in diagnosis, treatment and palliation of cholangiocarcinoma: 1990-2009. World J Gastroenterol 15:4240-4262, 2009 https://doi.org/10.3748/wjg.15.4240
  12. Glasbrenner B, Ardan M, Boeck W, Preclik G, Moller P, Adler G. Prospective evaluation of brush cytology of biliary strictures during endoscopic retrograde cholangiopancreatography. Endoscopy 31:712-717, 1999 https://doi.org/10.1055/s-1999-73
  13. de Bellis M, Fogel EL, Sherman S, Watkins JL, Chappo J, Younger C, Cramer H, Lehman GA. Influence of stricture dilation and repeat brushing on the cancer detection rate of brush cytology in the evaluation of malignant biliary obstruction. Gastrointest Endosc 58:176-182, 2003 https://doi.org/10.1067/mge.2003.345
  14. Mansfield JC, Griffin SM, Wadehra V, Matthewson K. A prospective evaluation of cytology from biliary strictures. Gut 40:671-677, 1997
  15. Dumonceau JM, Macias Gomez C, Casco C, Genevay M, Marcolongo M, Bongiovanni M, Morel P, Majno P, Hadengue A. Grasp or brush for biliary sampling at endoscopic retrograde cholangiography? A blinded randomized controlled trial. Am J Gastroenterol 103:333-340, 2008 https://doi.org/10.1111/j.1572-0241.2007.01543.x
  16. Ponchon T, Gagnon P, Berger F, Labadie M, Liaras A, Chavaillon A, Bory R. Value of endobiliary brush cytology and biopsies for the diagnosis of malignant bile duct stenosis: results of a prospective study. Gastrointest Endosc 42:565-572, 1995 https://doi.org/10.1016/S0016-5107(95)70012-9
  17. Pugliese V, Conio M, Nicolo G, Saccomanno S, Gatteschi B. Endoscopic retrograde forceps biopsy and brush cytology of biliary strictures: a prospective study. Gastrointest Endosc 42:520-526, 1995 https://doi.org/10.1016/S0016-5107(95)70004-8
  18. Jailwala J, Fogel EL, Sherman S, Gottlieb K, Flueckiger J, Bucksot LG, Lehman GA. Triple-tissue sampling at ERCP in malignant biliary obstruction. Gastrointest Endosc 51:383-390, 2000 https://doi.org/10.1016/S0016-5107(00)70435-4
  19. de Bellis M, Sherman S, Fogel EL, Cramer H, Chappo J, McHenry L, Jr., Watkins JL, Lehman GA. Tissue sampling at ERCP in suspected malignant biliary strictures (Part 2). Gastrointest Endosc 56:720-730, 2002 https://doi.org/10.1016/S0016-5107(02)70123-5
  20. Khan SA, Davidson BR, Goldin R, Pereira SP, Rosenberg WM, Taylor-Robinson SD, Thillainayagam AV, Thomas HC, Thursz MR, Wasan H. Guidelines for the diagnosis and treatment of cholangiocarcinoma: consensus document. Gut 51 Suppl 6:VI1-9, 2002 https://doi.org/10.1136/gut.51.1.e1
  21. Weber A, von Weyhern C, Fend F, Schneider J, Neu B, Meining A, Weidenbach H, Schmid RM, Prinz C. Endoscopic transpapillary brush cytology and forceps biopsy in patients with hilar cholangiocarcinoma. World J Gastroenterol 14:1097-1101, 2008 https://doi.org/10.3748/wjg.14.1097
  22. Bergquist A, Tribukait B, Glaumann H, Broome U. Can DNA cytometry be used for evaluation of malignancy and premalignancy in bile duct strictures in primary sclerosing cholangitis? J Hepatol 33:873-877, 2000 https://doi.org/10.1016/S0168-8278(00)80117-8
  23. Moreno Luna LE, Kipp B, Halling KC, Sebo TJ, Kremers WK, Roberts LR, Barr Fritcher EG, Levy MJ, Gores GJ. Advanced cytologic techniques for the detection of malignant pancreatobiliary strictures. Gastroenterology 131:1064-1072, 2006 https://doi.org/10.1053/j.gastro.2006.08.021
  24. Fritcher EG, Kipp BR, Halling KC, Oberg TN, Bryant SC, Tarrell RF, Gores GJ, Levy MJ, Clayton AC, Sebo TJ, Roberts LR. A multivariable model using advanced cytologic methods for the evaluation of indeterminate pancreatobiliary strictures. Gastroenterology 136:2180-2186, 2009 https://doi.org/10.1053/j.gastro.2009.02.040
  25. Wamsteker EJ, Anderson MA. Fluorescence in situ hybridization for the detection of malignant bile duct strictures: has FISH found a new pond? Am J Gastroenterol 99:1682-1683, 2004 https://doi.org/10.1111/j.1572-0241.2004.40744.x
  26. Kipp BR, Stadheim LM, Halling SA, Pochron NL, Harmsen S, Nagorney DM, Sebo TJ, Therneau TM, Gores GJ, de Groen PC, Baron TH, Levy MJ, Halling KC, Roberts LR. A comparison of routine cytology and fluorescence in situ hybridization for the detection of malignant bile duct strictures. Am J Gastroenterol 99:1675-1681, 2004 https://doi.org/10.1111/j.1572-0241.2004.30281.x
  27. DeWitt J, Misra VL, Leblanc JK, McHenry L, Sherman S. EUS-guided FNA of proximal biliary strictures after negative ERCP brush cytology results. Gastrointest Endosc 64:325-333, 2006 https://doi.org/10.1016/j.gie.2005.11.064
  28. Garrow D, Miller S, Sinha D, Conway J, Hoffman BJ, Hawes RH, Romagnuolo J. Endoscopic ultrasound: a meta-analysis of test performance in suspected biliary obstruction. Clin Gastroenterol Hepatol 5:616-623, 2007 https://doi.org/10.1016/j.cgh.2007.02.027
  29. Fritscher-Ravens A, Broering DC, Knoefel WT, Rogiers X, Swain P, Thonke F, Bobrowski C, Topalidis T, Soehendra N. EUS-guided fine-needle aspiration of suspected hilar cholangiocarcinoma in potentially operable patients with negative brush cytology. Am J Gastroenterol 99:45-51, 2004 https://doi.org/10.1046/j.1572-0241.2003.04006.x
  30. Rosch T, Hofrichter K, Frimberger E, Meining A, Born P, Weigert N, Allescher HD, Classen M, Barbur M, Schenck U, Werner M. ERCP or EUS for tissue diagnosis of biliary strictures? A prospective comparative study. Gastrointest Endosc 60:390-396, 2004 https://doi.org/10.1016/S0016-5107(04)01732-8
  31. Larghi A, Lecca PG, Ardito F, Rossi ED, Fadda G, Nuzzo G, Costamagna G. Evaluation of hilar biliary strictures by using a newly developed forward-viewing therapeutic echoendoscope: preliminary results of an ongoing experience. Gastrointest Endosc 69:356-360, 2009 https://doi.org/10.1016/j.gie.2008.08.038
  32. Malhi H, Gores GJ. Cholangiocarcinoma: modern advances in understanding a deadly old disease. J Hepatol 45:856-867, 2006 https://doi.org/10.1016/j.jhep.2006.09.001
  33. Tamada K, Ido K, Ueno N, Ichiyama M, Tomiyama T, Nishizono T, Wada S, Tano S, Aizawa T, Kimura K. Assessment of the course and variations of the hepatic artery in bile duct cancer by intraductal ultrasonography. Gastrointest Endosc 44:249-256, 1996 https://doi.org/10.1016/S0016-5107(96)70160-8
  34. Menzel J, Poremba C, Dietl KH, Domschke W. Preoperative diagnosis of bile duct strictures-comparison of intraductal ultrasonography with conventional endosonography. Scand J Gastroenterol 35:77-82, 2000 https://doi.org/10.1080/003655200750024579
  35. Stavropoulos S, Larghi A, Verna E, Battezzati P, Stevens P. Intraductal ultrasound for the evaluation of patients with biliary strictures and no abdominal mass on computed tomography. Endoscopy 37:715-721, 2005 https://doi.org/10.1055/s-2005-870132
  36. Tamada K, Tomiyama T, Wada S, Ohashi A, Satoh Y, Ido K, Sugano K. Endoscopic transpapillary bile duct biopsy with the combination of intraductal ultrasonography in the diagnosis of biliary strictures. Gut 50:326-331, 2002 https://doi.org/10.1136/gut.50.3.326
  37. Domagk D, Wessling J, Reimer P, Hertel L, Poremba C, Senninger N, Heinecke A, Domschke W, Menzel J. Endoscopic retrograde cholangiopancreatography, intraductal ultrasonography, and magnetic resonance cholangiopancreatography in bile duct strictures: a prospective comparison of imaging diagnostics with histopathological correlation. Am J Gastroenterol 99:1684-1689, 2004 https://doi.org/10.1111/j.1572-0241.2004.30347.x
  38. Tamada K, Tomiyama T, Ohashi A, Wada S, Satoh Y, Miyata T, Ido K, Sugano K. Preoperative assessment of extrahepatic bile duct carcinoma using three-dimensional intraductal US. Gastrointest Endosc 50:548-554, 1999 https://doi.org/10.1016/S0016-5107(99)70082-9
  39. Nimura Y. Staging cholangiocarcinoma by cholangioscopy. HPB (Oxford) 10:113-115, 2008 https://doi.org/10.1080/13651820801992658
  40. Nguyen NQ, Binmoeller KF, Shah JN. Cholangioscopy and pancreatoscopy (with videos). Gastrointest Endosc 70:1200-1210, 2009 https://doi.org/10.1016/j.gie.2009.07.010
  41. Fukuda Y, Tsuyuguchi T, Sakai Y, Tsuchiya S, Saisyo H. Diagnostic utility of peroral cholangioscopy for various bile-duct lesions. Gastrointest Endosc 62:374-382, 2005 https://doi.org/10.1016/j.gie.2005.04.032
  42. Itoi T, Sofuni A, Itokawa F, Tsuchiya T, Kurihara T, Ishii K, Tsuji S, Moriyasu F, Gotoda T. Peroral cholangioscopic diagnosis of biliary-tract diseases by using narrow-band imaging (with videos). Gastrointest Endosc 66:730-736, 2007 https://doi.org/10.1016/j.gie.2007.02.056
  43. Itoi T, Neuhaus H, Chen YK. Diagnostic value of image-enhanced video cholangiopancreatoscopy. Gastrointest Endosc Clin N Am 19:557-566, 2009 https://doi.org/10.1016/j.giec.2009.06.002
  44. Itoi T, Sofuni A, Itokawa F, Tsuchiya T, Kurihara T. Evaluation of peroral videocholangioscopy using narrow-band imaging for diagnosis of intraductal papillary neoplasm of the bile duct. Dig Endosc 21 Suppl 1:S103-107, 2009 https://doi.org/10.1111/j.1443-1661.2009.00849.x
  45. Kawakami H, Kuwatani M, Etoh K, Haba S, Yamato H, Shinada K, Nakanishi Y, Tanaka E, Hirano S, Kondo S, Kubota K, Asaka M. Endoscopic retrograde cholangiography versus peroral cholangioscopy to evaluate intraepithelial tumor spread in biliary cancer. Endoscopy 41:959-964, 2009 https://doi.org/10.1055/s-0029-1215178
  46. Itoi T, Osanai M, Igarashi Y, Tanaka K, Kida M, Maguchi H, Yasuda K, Okano N, Imaizumi H, Yokoyama T, Itokawa F. Diagnostic peroral video cholangioscopy is an accurate diagnostic tool for patients with bile duct lesions. Clin Gastroenterol Hepatol 8:934-938, 2010 https://doi.org/10.1016/j.cgh.2010.06.029
  47. Chen YK. Preclinical characterization of the Spyglass peroral cholangiopancreatoscopy system for direct access, visualization, and biopsy. Gastrointest Endosc 65:303-311, 2007 https://doi.org/10.1016/j.gie.2006.07.048
  48. Chen YK, Pleskow DK. SpyGlass single-operator peroral cholangiopancreatoscopy system for the diagnosis and therapy of bile-duct disorders: a clinical feasibility study (with video). Gastrointest Endosc 65:832-841, 2007 https://doi.org/10.1016/j.gie.2007.01.025
  49. Choi HJ, Moon JH, Ko BM, Hong SJ, Koo HC, Cheon YK, Cho YD, Lee JS, Lee MS, Shim CS. Overtube-balloon-assisted direct peroral cholangioscopy by using an ultra-slim upper endoscope (with videos). Gastrointest Endosc 69:935-940, 2009 https://doi.org/10.1016/j.gie.2008.08.043
  50. Moon JH, Ko BM, Choi HJ, Hong SJ, Cheon YK, Cho YD, Lee JS, Lee MS, Shim CS. Intraductal balloon-guided direct peroral cholangioscopy with an ultraslim upper endoscope (with videos). Gastrointest Endosc 70:297-302, 2009 https://doi.org/10.1016/j.gie.2008.11.019
  51. Moon JH, Ko BM, Choi HJ, Koo HC, Hong SJ, Cheon YK, Cho YD, Lee MS, Shim CS. Direct peroral cholangioscopy using an ultra-slim upper endoscope for the treatment of retained bile duct stones. Am J Gastroenterol 104:2729-2733, 2009 https://doi.org/10.1038/ajg.2009.435
  52. Singh P, Chak A, Willis JE, Rollins A, Sivak MV, Jr. In vivo optical coherence tomography imaging of the pancreatic and biliary ductal system. Gastrointest Endosc 62:970-974, 2005 https://doi.org/10.1016/j.gie.2005.06.054
  53. Arvanitakis M, Hookey L, Tessier G, Demetter P, Nagy N, Stellke A, De Maertelaer V, Deviere J, Le Moine O. Intraductal optical coherence tomography during endoscopic retrograde cholangiopancreatography for investigation of biliary strictures. Endoscopy 41:696-701, 2009 https://doi.org/10.1055/s-0029-1214950
  54. Meining A. Confocal endomicroscopy. Gastrointest Endosc Clin N Am 19:629-635, 2009 https://doi.org/10.1016/j.giec.2009.07.005
  55. Wallace MB, Fockens P. Probe-based confocal laser endomicroscopy. Gastroenterology 136:1509-1513, 2009 https://doi.org/10.1053/j.gastro.2009.03.034