Cholangiopancreatoscopy for targeted biopsies of the bile and pancreatic ducts.
Establishing a tissue diagnosis in patients with suspected pancreaticobiliary malignancies remains challenging. Endoscopic retrograde cholangiopancreatography (ERCP)-based sampling methods have been reviewed in a previous issue of this journal but, unfortunately, the diagnostic yield continues to be inadequate in a significant minority of patients. The availability and image quality of cholangioscopy and pancreatoscopy have advanced in the last few years and our ability to make a diagnosis on imaging alone is improving. However, a definitive diagnosis requires tissue; cholangiopancreatoscopy allows targeted biopsies of the epithelium of the biliary and pancreatic ducts. This article reviews the evidence that cholangioscopy- and pancreatoscopy-guided biopsies improves diagnostic yield over ERCP-based tissue sampling techniques.
Iqbal
Shahzad
S
Division of Digestive and Liver Diseases, Department of Medicine, Columbia University College of Physicians and Surgeons, P&S 10-508, 630 West 168th Street, NY 10032, USA.
Stevens
Peter D
PD
D001650:Bile Duct Neoplasms / Q000175:diagnosis* / Q000473:pathology; D001706:Biopsy / Q000379:methods; D021441:Carcinoma, Pancreatic Ductal / Q000175:diagnosis* / Q000473:pathology; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000379:methods*; D006801:Humans; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000473:pathology; D025321:Surgery, Computer-Assisted