Journal List > J Korean Soc Radiol > v.67(1) > 1087154

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Bahn, Kim, An, and Kim: Percutaneous Transluminal Biopsy Using 7-F Forceps for Diagnosing Malignant Biliary Obstruction
Interventional Radiology
Journal of the Korean Society of Radiology

Journal of the Korean Society of Radiology 2012; 67(1): 17-23.

Published online: 10 July 2012

DOI: https://doi.org/10.0000/jksr.2012.67.1.17

Percutaneous Transluminal Biopsy Using 7-F Forceps for Diagnosing Malignant Biliary Obstruction

Young Eun Bahn, MD, Young Hwan Kim, MD, Eun Jung An, MD, See Hyung Kim, MD

Department of Radiology, Dongsan Medical Center, Keimyung University College of Medicine, Daegu, Korea.

Corresponding author: Young Hwan Kim, MD. Department of Radiology, Dongsan Medical Center, Keimyung University College of Medicine, 56 Dalseong-ro, Jung-gu, Daegu 700-712, Korea. Tel. 82-53-250-7770, Fax. 82-53-250-7766, yhkim68@dsmc.or.kr

Received 27 November 2011       Accepted 30 April 2012

Copyright © 2012 The Korean Society of Radiology

Abstract

Purpose

To evaluate the usefulness of the percutaneous transluminal biopsy using 7-F forceps for diagnosing malignant biliary obstruction.

Materials and Methods

One hundred and seven consecutive patients with obstructive jaundice underwent transluminal forceps biopsy. The lesions involved the common bile duct (n = 33), common hepatic duct (n = 13), hilum (n = 17), right or left intrahepatic bile duct (n = 32), multiple sites (extra- and intrahepatic ducts, n = 7), or anastomotic sites (n = 5). In each patient, an average of three specimens was taken with 7-F biopsy forceps through a transhepatic biliary drainage tract. The final diagnosis was confirmed with pathologic findings, or a clinical and radiologic follow-up.

Results

The final diagnoses showed malignancies in 75 patients and benign biliary obstructions in 32 patients. Pathologic classifications of malignancies established by forceps biopsy included 67 adenocarcinomas, 1 adenosquamous cell carcinoma, and 1 hepatocelluar carcinoma. There were 6 false-negative diagnoses. The diagnostic performance of transluminal forceps biopsy in malignant biliary obstruction had a sensitivity of 92%, specificity of 100%, positive predictive value of 100%, a negative predictive value of 84.2%, and an accuracy of 94.2%.

Conclusion

Percutaneous transluminal forceps biopsy is a safe procedure that is easy to perform through a transhepatic biliary drainage tract. It is a highly accurate technique for diagnosing malignant biliary obstructions.

Keywords: Bile Ducts, Biopsy, Bile Ducts, Percutaneous Drainage

References

1. Droese M, Altmannsberger M, Kehl A, Lankisch PG, Weiss R, Weber K, et al. Ultrasound-guided percutaneous fine needle aspiration biopsy of abdominal and retroperitoneal masses. Accuracy of cytology in the diagnosis of malignancy, cytologic tumor typing and use of antibodies to intermediate filaments in selected cases. Acta Cytol. 1984. 28:368–384.
2. Welch TJ, Sheedy PF 2nd, Johnson CD, Johnson CM, Stephens DH. CT-guided biopsy: prospective analysis of 1,000 procedures. Radiology. 1989. 171:493–496.
3. Kim CS, Han YM, Song HY, Choi KC, Kim DG, Cho BH. Percutaneous transhepatic biliary biopsy using gastrofiberscopic biopsy forceps. J Korean Med Sci. 1992. 7:325–332.
4. Donald JJ, Fache JS, Burhenne HJ. Percutaneous transluminal biopsy of the biliary tract. Can Assoc Radiol J. 1993. 44:185–188.
5. Tsai CC, Mo LR, Chou CY, Han SJ, Lin RC, Kuo JY, et al. Percutaneous transhepatic transluminal forceps biopsy in obstructive jaundice. Hepatogastroenterology. 1997. 44:770–773.
6. Jung GS, Huh JD, Lee SU, Han BH, Chang HK, Cho YD. Bile duct: analysis of percutaneous transluminal forceps biopsy in 130 patients suspected of having malignant biliary obstruction. Radiology. 2002. 224:725–730.
7. Nimura Y. Staging of biliary carcinoma: cholangiography and cholangioscopy. Endoscopy. 1993. 25:76–80.
8. Savader SJ, Prescott CA, Lund GB, Osterman FA. Intraductal biliary biopsy: comparison of three techniques. J Vasc Interv Radiol. 1996. 7:743–750.
9. Sato M, Inoue H, Ogawa S, Ohashi S, Maetani I, Igarashi Y, et al. Limitations of percutaneous transhepatic cholangioscopy for the diagnosis of the intramural extension of bile duct carcinoma. Endoscopy. 1998. 30:281–288.
10. Sawada S, Tanigawa N. Han MC, Park JH. Percutaneous transhepatic biliary drainage. Interventional Radiology. 1999. Seoul: Ilchokak;540–552.
11. Hall-Craggs MA, Lees WR. Fine-needle aspiration biopsy: pancreatic and biliary tumors. AJR Am J Roentgenol. 1986. 147:399–403.
12. Chitwood WR Jr, Meyers WC, Heaston DK, Herskovic AM, McLeod ME, Jones RS. Diagnosis and treatment of primary extrahepatic bile duct tumors. Am J Surg. 1982. 143:99–106.
13. Evander A, Fredlund P, Hoevels J, Ihse I, Bengmark S. Evaluation of aggressive surgery for carcinoma of the extrahepatic bile ducts. Ann Surg. 1980. 191:23–29.
14. Ryan ME. Cytologic brushings of ductal lesions during ERCP. Gastrointest Endosc. 1991. 37:139–142.
15. Cropper LD Jr, Gold RE. Simplified brush biopsy of the bile ducts. Radiology. 1983. 148:307–308.
16. Mendez G Jr, Russell E, Levi JU, Koolpe H, Cohen M. Percutaneous brush biopsy and internal drainage of biliary tree through endoprosthesis. AJR Am J Roentgenol. 1980. 134:653–659.
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