Evaluation of hilar biliary strictures by using a newly developed forward-viewing therapeutic echoendoscope: preliminary results of an ongoing experience.
BACKGROUND
Obtaining a definitive tissue diagnosis in patients with hilar biliary strictures (HBS) is often difficult.


OBJECTIVE
To describe our experience using a newly developed forward-viewing linear echoendoscope (FVL-EUS) with FNA as a primary diagnostic tool in patients with HBS.


METHODS
Case series.


METHODS
A tertiary care, academic medical center.


METHODS
Four patients with HBS who underwent the procedure.


METHODS
Performance of FNA with the FVL-EUS.


RESULTS
Visualization and puncture of the primary lesion with a definitive tissue diagnosis was obtained in all of the 4 cases performed. Metastatic hilar cholangiocarcinoma and recurrent neuroendocrine tumor were diagnosed in 2 patients and followed by placement of a self-expandable metal stent, when possible. In the other 2 patients, a diagnosis of resectable hilar cholangiocarcinoma and poorly differentiated adenocarcinoma of unclear origin without evidence of vascular involvement was made, and plastic stents were placed before surgery; the first patient was found to have peritoneal metastases, and resection was aborted, and in the second patient, a gallbladder tumor was diagnosed in the surgical specimen.


CONCLUSIONS
The small number of patients.


CONCLUSIONS
These preliminary data suggest that FVL-EUS used as a primary tool for the evaluation of patients with HBS may be of value and should be further explored in properly designed studies with a meaningful number of patients.
Larghi
Alberto
A
Digestive Endoscopy Unit, Catholic University, Rome, Italy.
Lecca
Piera Giuseppina
PG
Ardito
Francesco
F
Rossi
Esther Diana
ED
Fadda
Guido
G
Nuzzo
Gennaro
G
Costamagna
Guido
G
D000230:Adenocarcinoma / Q000175:diagnosis; D000368:Aged; D001650:Bile Duct Neoplasms / Q000175:diagnosis; D001653:Bile Ducts, Intrahepatic; D044963:Biopsy, Fine-Needle; D018281:Cholangiocarcinoma / Q000175:diagnosis; D002780:Cholestasis, Intrahepatic / Q000175:diagnosis*; D019160:Endosonography / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015607:Stents