English (United Kingdom)

https://curated-unify.zendy.io/wp-json/zendy-region/v1/featured_content/oa?rat=en

https://curated-unify.zendy.io/wp-json/zendy-region/v1/highlighted_journal/

Global: Zendy Plus annual

Presents the access of premium content as premium feature

Premium Content

Presents the keyphrase highlighting as premium feature

Keyphrase Highlighting

Presents the summarisation as premium feature

Summarisation

Insights

Presents the pdf analysis as premium feature

PDF Analysis

Presents the zaia usage as premium feature

ZAIA

Global: Zendy Plus monthly

Global: Zendy Tools annual

Global: Zendy Tools monthly

Global: Zendy Free Plan

An endoscopic transpapillary mapping biopsy is useful for evaluating intraepithelial tumor spread in bile duct cancers [1,2]; however, it is occasionally technically difficult to advance the biopsy forceps through a biliary stricture. Here, we describe the case of a patient with a hilar biliary stricture who underwent a selective mapping biopsy. The biopsy technique described is suitable where the bile duct is inaccessible when introducing conventional biopsy forceps. A 69-year-old woman presented with obstructive jaundice. Magnetic resonance cholangiography indicated a hilar biliary stricture (●" Fig.1). We attempted a transpapillary intraductal biopsy of the biliary stricture and a mapping biopsy using conventional biopsy forceps to confirm the definitive diagnosis and look for proximal intraepithelial tumor spread; however, the forceps could not be passed through the stricture. Therefore, we attempted a guidewire-assisted intraductal biopsy. First, a 0.025-inch guidewire (VisiGlide 2TM; Olympus Medical Systems, Tokyo, Japan) was placed at the left intrahepatic bile duct. The guidewire was gripped by the biopsy forceps (Radial JawTM 4P; Boston Scientific Japan, Tokyo, Japan) outside the papilla (●" Fig.2). Thereafter, the biopsy forceps, which were still securely gripping the guidewire, were slid into the bile duct and advanced through the hilar biliary stricture under fluoroscopic guidance (●" Fig.3,●" Video 1). Finally, a successful biopsywas performed from the B4 confluencewithout any complications occurring. Intraductal biopsy specimens of biliary strictures can be obtained under fluoroscopic guidance using conventional biopsy forceps, biliary introducers [3], or ropeFig.3 Fluoroscopic image showing the biopsy forceps gripping the guidewire, while being advanced through the biliary stricture. Fig.2 Endoscopic image showing the jaw configuration biopsy forceps: a open and positioned just outside the papilla; b gripping the guidewire outside the papilla. Fig.1 Magnetic resonance cholangiography image in a 69-year-old woman with obstructive jaundice showing a hilar biliary stricture.

A guidewire-assisted biopsy technique to assist advancement through a biliary stricture to perform selective mapping biopsy