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Prospective evaluation of the short access cholangioscopy for stone clearance and evaluation of indeterminate strictures

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Hepatobiliary & Pancreatic Diseases International 2017年第1期16卷 96-103页

作者： Athanasios D Sioulas Muhammad A El-Masry Stefan Groth guido schachschal Mario Anders Thomas Rosch Ulrike Denzer Department of Interdisciplinary Endoscopy University Hospital Hamburg-Eppendorf MartinistraBe 52 20246 Hamburg Germany Division of Gastroenterology Department of Internal Medicine Assiut University Hospital Al Walideyah Al Qebleyah Qesm Than Asyut Assiut Governorate Egypt

BACKGROUND： Peroral cholangioscopy facilitates diagnosis and therapy of biliary disorders. This study prospectively evaluated a new short access cholangioscopy. METHODS： Consecutive patients were included as follows： difficult stones （group 1） underwent cholangioscopy with electrohydraulic lithotripsy and indeterminate biliary strictures （group 2） were evaluated with macroscopic assessment and cholangioscopy guided biopsy sampling. We evaluated the complete stone clearance rate （group 1） and diagnostic accu- racy （group 2）. Follow-up was performed over a median of 13 and I6 months, respectively. RESULTS： Group 1 （n=21）： complete stone clearance defined as lack of stones in cholangiography and stone removal dur- ing cholangioscopy was achieved in 15 （71.4%） patients. Clini- cal stone clearance defined as lack of symptoms, laboratory abnormalities and hospital visits during follow-up, irrespec- tive of stone clearance was evident in 17 （81.0%） patients. One serious adverse event occurred （bile duct perforation）. Group 2 （n=28）： malignancy was confirmed in 15 patients. Sensitiv- ity, specificity and diagnostic accuracy of cholangioscopy were 85.7%, 75.0% and 80.7%, respectively. Sensitivity, specificity and diagnostic accuracy of biopsies were 54.5%, 100.0% and 72.2%, respectively. No serious adverse events occurred, and one patient was lost to ***： The novel system enabled complex stone treatment and biliary stricture diagnosis. Cholangioscopy outperformed direct biopsy regarding characterization of in- determinate strictures.

关键词： biliary tract diseases novel cholangioscopy feasibility

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22-gauge core vs 22-gauge aspiration needle for endoscopic ultrasound-guided sampling of abdominal masses

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World Journal of Gastroenterology 2016年第39期22卷 8820-8830页

作者： William Sterlacci Athanasios D Sioulas Lothar Veits Pervin G?nüllü guido schachschal Stefan Groth Mario Anders Christos K Kontos Theodoros Topalidis Andrea Hinsch Michael Vieth Thomas R?sch Ulrike W Denzer Institute of Pathology Clinic of Bayreuth Department of Interdisciplinary Endoscopy University Hospital Hamburg-Eppendorf Department of Biochemistry and Molecular Biology University of Athens Institute of Pathology Institute of Pathology University Hospital Hamburg-Eppendorf

AIM To compare the aspiration needle(AN) and core biopsy needle(PC) in endoscopic ultrasound-guided fine needle aspiration(EUS-FNA) of abdominal *** Consecutive patients referred for EUS-FNA were included in this prospective single-center trial. Each patient underwent a puncture of the lesion with both standard 22-gauge(G) AN(Echo Tip Ultra; Cook Medical, Bloomington, Indiana, United States) and the novel 22 G PC(Echo Tip Pro Core; Cook Medical, Bloomington, Indiana, United States) in a randomized fashion; histology was attempted in the PC group only. The main study endpoint was the overall diagnostic accuracy, including the contribution of histology to the final diagnosis. Secondary outcome measures included material adequacy, number of needle passes, and *** Fifty six consecutive patients(29 men; mean age 68 years) with pancreatic lesions(n = 38), lymphadenopathy(n = 13), submucosal tumors(n = 4), or others lesions(n = 1) underwent EUS-FNA using both of the needles in a randomized order. AN and PC reached similar overall results for diagnostic accuracy(AN: 88.9 vs PC: 96.1, P = 0.25), specimen adequacy(AN: 96.4% vs PC: 91.1%, P = 0.38), mean number of passes(AN: 1.5 vs PC: 1.7, P = 0.14), mean cellularity score(AN: 1.7 vs PC: 1.1, P = 0.058), and complications(none). A diagnosis on the basis of histology was achieved in the PC group in 36(64.3%) patients, and in 2 of those as the sole modality. In patients with available histology the mean cellularity score was higher for AN(AN: 1.7 vs PC: 1.0, P = 0.034); no other differences were of statistical *** Both needles achieved high overall diagnostic yields and similar performance characteristics for cytological diagnosis; histological analysis was only possible in 2/3 of cases with the new needle.

关键词： Endoscopic ultrasound Cytology Fine needle aspiration Abdominal tumors Core biopsy needle

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