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Comparison of tube-assisted mapping biopsy with digital single-operator peroral cholangioscopy for preoperative evaluation of biliary tract cancer

  • Tsuyoshi Takeda (Department of Hepato-Biliary-Pancreatic Medicine, Cancer Institute Hospital of Japanese Foundation for Cancer Research) ;
  • Takashi Sasaki (Department of Hepato-Biliary-Pancreatic Medicine, Cancer Institute Hospital of Japanese Foundation for Cancer Research) ;
  • Takafumi Mie (Department of Hepato-Biliary-Pancreatic Medicine, Cancer Institute Hospital of Japanese Foundation for Cancer Research) ;
  • Takeshi Okamoto (Department of Hepato-Biliary-Pancreatic Medicine, Cancer Institute Hospital of Japanese Foundation for Cancer Research) ;
  • Chinatsu Mori (Department of Hepato-Biliary-Pancreatic Medicine, Cancer Institute Hospital of Japanese Foundation for Cancer Research) ;
  • Takaaki Furukawa (Department of Hepato-Biliary-Pancreatic Medicine, Cancer Institute Hospital of Japanese Foundation for Cancer Research) ;
  • Yuto Yamada (Department of Hepato-Biliary-Pancreatic Medicine, Cancer Institute Hospital of Japanese Foundation for Cancer Research) ;
  • Akiyoshi Kasuga (Department of Hepato-Biliary-Pancreatic Medicine, Cancer Institute Hospital of Japanese Foundation for Cancer Research) ;
  • Masato Matsuyama (Department of Hepato-Biliary-Pancreatic Medicine, Cancer Institute Hospital of Japanese Foundation for Cancer Research) ;
  • Masato Ozaka (Department of Hepato-Biliary-Pancreatic Medicine, Cancer Institute Hospital of Japanese Foundation for Cancer Research) ;
  • Naoki Sasahira (Department of Hepato-Biliary-Pancreatic Medicine, Cancer Institute Hospital of Japanese Foundation for Cancer Research)
  • 투고 : 2021.09.09
  • 심사 : 2021.11.19
  • 발행 : 2022.07.30

초록

Background/Aims: Digital single-operator cholangioscopy (DSOC)-guided mapping biopsy (DMB) and tube-assisted mapping biopsy (TMB) are two techniques used for preoperative evaluation of biliary tract cancer (BTC). However, data regarding the diagnostic performance of these techniques are limited. Methods: We retrospectively examined consecutive patients with BTC who underwent either technique at our institution between 2018 and 2020. We evaluated the technical success rate, adequate tissue acquisition rate, and diagnostic performance of these techniques for the evaluation of lateral spread of BTC. Results: A total of 54 patients were included in the study. The technical success rate of reaching the target sites was 95% for DMB and 100% for TMB. The adequate tissue acquisition rate was 61% for DMB and 69% for TMB. The adequate tissue acquisition rate was low, especially for target sites beyond the secondary biliary radicles. The sensitivity of DMB alone was 39%, which improved to 65% when combined with visual impression. Experts demonstrated a higher negative predictive value and diagnostic accuracy with respect to both DSOC visual impression and DMB for the evaluation of lateral spread of BTC compared to trainees. Conclusions: Adequate tissue acquisition rates were similar between the two techniques. Since DMB requires expertise, TMB may be an acceptable option when DSOC is unavailable or when DSOC expertise is limited.

키워드

참고문헌

  1. Igami T, Nagino M, Oda K, et al. Clinicopathologic study of cholangiocarcinoma with superficial spread. Ann Surg 2009;249:296-302. https://doi.org/10.1097/SLA.0b013e318190a647
  2. Mohamadnejad M, DeWitt JM, Sherman S, et al. Role of EUS for preoperative evaluation of cholangiocarcinoma: a large single-center experience. Gastrointest Endosc 2011;73:71-78. https://doi.org/10.1016/j.gie.2010.08.050
  3. Ito K, Sakamoto Y, Isayama H, et al. The impact of MDCT and endoscopic transpapillary mapping biopsy to predict longitudinal spread of extrahepatic cholangiocarcinoma. J Gastrointest Surg 2018;22:1528-1537. https://doi.org/10.1007/s11605-018-3793-y
  4. Watadani T, Akahane M, Yoshikawa T, et al. Preoperative assessment of hilar cholangiocarcinoma using multidetector-row CT: correlation with histopathological findings. Radiat Med 2008;26:402-407. https://doi.org/10.1007/s11604-008-0249-4
  5. Park HS, Lee JM, Choi JY, et al. Preoperative evaluation of bile duct cancer: MRI combined with MR cholangiopancreatography versus MDCT with direct cholangiography. AJR Am J Roentgenol 2008;190:396-405. https://doi.org/10.2214/AJR.07.2310
  6. Noda Y, Fujita N, Kobayashi G, et al. Intraductal ultrasonography before biliary drainage and transpapillary biopsy in assessment of the longitudinal extent of bile duct cancer. Dig Endosc 2008;20:73-78. https://doi.org/10.1111/j.1443-1661.2008.00779.x
  7. Kawakami H, Kuwatani M, Abe Y, et al. A guidewire-assisted biopsy technique to assist advancement through a biliary stricture to perform selective mapping biopsy. Endoscopy 2015;47 Suppl 1 UCTN: E217-E218. https://doi.org/10.1055/s-0034-1391827
  8. Hijioka S, Hara K, Mizuno N, et al. A novel technique for endoscopic transpapillary "mapping biopsy specimens" of superficial intraductal spread of bile duct carcinoma (with videos). Gastrointest Endosc 2014;79:1020-1025. https://doi.org/10.1016/j.gie.2014.01.040
  9. Hamada T, Takahara N, Nakai Y, et al. The "zipline" technique for endoscopic transpapillary biliary biopsy. Endoscopy 2020;52:236-237. https://doi.org/10.1055/a-1015-6609
  10. Manta R, Frazzoni M, Conigliaro R, et al. SpyGlass single-operator peroral cholangioscopy in the evaluation of indeterminate biliary lesions: a single-center, prospective, cohort study. Surg Endosc 2013;27:1569-1572. https://doi.org/10.1007/s00464-012-2628-2
  11. Draganov PV, Chauhan S, Wagh MS, et al. Diagnostic accuracy of conventional and cholangioscopy-guided sampling of indeterminate biliary lesions at the time of ERCP: a prospective, long-term follow-up study. Gastrointest Endosc 2012;75:347-353. https://doi.org/10.1016/j.gie.2011.09.020
  12. Gerges C, Beyna T, Tang RS, et al. Digital single-operator peroral cholangioscopy-guided biopsy sampling versus ERCP-guided brushing for indeterminate biliary strictures: a prospective, randomized, multicenter trial (with video). Gastrointest Endosc 2020;91:1105-1113. https://doi.org/10.1016/j.gie.2019.11.025
  13. Navaneethan U, Hasan MK, Lourdusamy V, et al. Single-operator cholangioscopy and targeted biopsies in the diagnosis of indeterminate biliary strictures: a systematic review. Gastrointest Endosc 2015;82:608-614.e2. https://doi.org/10.1016/j.gie.2015.04.030
  14. Onoyama T, Hamamoto W, Sakamoto Y, et al. Peroral cholangioscopy- guided forceps mapping biopsy for evaluation of the lateral extension of biliary tract cancer. J Clin Med 2021;10:597.
  15. Ogawa T, Kanno Y, Koshita S, et al. Cholangioscopy- versus fluoroscopy- guided transpapillary mapping biopsy for preoperative evaluation of extrahepatic cholangiocarcinoma: a prospective randomized crossover study. Surg Endosc 2021;35:6481-6488. https://doi.org/10.1007/s00464-020-08141-y
  16. Jang S, Stevens T, Kou L, et al. Efficacy of digital single-operator cholangioscopy and factors affecting its accuracy in the evaluation of indeterminate biliary stricture. Gastrointest Endosc 2020;91:385-393. e1. https://doi.org/10.1016/j.gie.2019.09.015
  17. Ko SW, Lee SS, So H, et al. A novel method of biopsy for indeterminate pancreaticobiliary strictures: tube-assisted biopsy. Endoscopy 2020;52:589-594. https://doi.org/10.1055/a-1127-3265
  18. Okada H, Uza N, Matsumori T, et al. A novel technique for mapping biopsy of bile duct cancer. Endoscopy 2021;53:647-651. https://doi.org/10.1055/a-1248-2138
  19. Cotton PB, Eisen GM, Aabakken L, et al. A lexicon for endoscopic adverse events: report of an ASGE workshop. Gastrointest Endosc 2010;71:446-454. https://doi.org/10.1016/j.gie.2009.10.027
  20. Kanda Y. Investigation of the freely available easy-to-use software 'EZR' for medical statistics. Bone Marrow Transplant 2013;48:452-458. https://doi.org/10.1038/bmt.2012.244
  21. Kulpatcharapong S, Pittayanon R, J Kerr S, et al. Diagnostic performance of different cholangioscopes in patients with biliary strictures: a systematic review. Endoscopy 2020;52:174-185. https://doi.org/10.1055/a-1083-6105
  22. Kanno Y, Koshita S, Ogawa T, et al. Peroral cholangioscopy by Spy-Glass DS versus CHF-B260 for evaluation of the lateral spread of extrahepatic cholangiocarcinoma. Endosc Int Open 2018;6:E1349-E1354. https://doi.org/10.1055/a-0743-5283
  23. Nishikawa T, Tsuyuguchi T, Sakai Y, et al. Preoperative assessment of longitudinal extension of cholangiocarcinoma with peroral video-cholangioscopy: a prospective study. Dig Endosc 2014;26:450-457. https://doi.org/10.1111/den.12159
  24. Onoyama T, Takeda Y, Kawata S, et al. Adequate tissue acquisition rate of peroral cholangioscopy-guided forceps biopsy. Ann Transl Med 2020;8:1073.
  25. Osanai M, Itoi T, Igarashi Y, et al. Peroral video cholangioscopy to evaluate indeterminate bile duct lesions and preoperative mucosal cancerous extension: a prospective multicenter study. Endoscopy 2013;45:635-642. https://doi.org/10.1055/s-0032-1326631
  26. Ogawa T, Ito K, Koshita S, et al. Usefulness of cholangioscopic-guided mapping biopsy using SpyGlass DS for preoperative evaluation of extrahepatic cholangiocarcinoma: a pilot study. Endosc Int Open 2018;6:E199-E204. https://doi.org/10.1055/s-0043-117949