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Diagnostic yield of endoscopic retrograde cholangiography and of EUS‐guided fine needle aspiration sampling in gallbladder carcinomas
Author(s) -
Hijioka Susumu,
Hara Kazuo,
Mizuno Nobumasa,
Imaoka Hiroshi,
Ogura Takeshi,
Haba Shin,
Mekky Mohamed A.,
Bhatia Vikram,
Hosoda Waki,
Yatabe Yasushi,
Shimizu Yasuhiro,
Niwa Yasumasa,
Tajika Masahiro,
Kondo Shinya,
Tanaka Tsutomu,
Tamada Kiichi,
Yamao Kenji
Publication year - 2012
Publication title -
journal of hepato‐biliary‐pancreatic sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.63
H-Index - 60
eISSN - 1868-6982
pISSN - 1868-6974
DOI - 10.1007/s00534-011-0482-6
Subject(s) - medicine , gallbladder , radiology , endoscopic ultrasound , sampling (signal processing) , fine needle aspiration , carcinoma , pathological , pancreatitis , biopsy , gastroenterology , filter (signal processing) , computer science , computer vision
Background Obtaining histological evidence of gallbladder carcinoma (GBC) is difficult due to its extraductal nature, and pathological confirmation remains challenging. We compared the diagnostic value and safety of endoscopic ultrasound‐guided fine‐needle aspiration (EUS‐FNA) with endoscopic retrograde cholangiography (ERC) in patients with suspected GBC. Patients Eighty‐three patients with GBC were evaluated. Prior to definitive management, pathological evidence of GBC was obtained through either ERC cytopathologic sampling ( n = 33), EUS‐FNA ( n = 24) or both ( n = 26). Results Among the 83 patients, 59 (71.0%) with biliary obstruction were sampled using ERC with 47.4% (28/59) sensitivity. In 19 of the remaining 31 cases, EUS‐FNA sampling had 100% diagnostic sensitivity. Likewise, 50 (60.2%) of the 83 patients with suspected GBC underwent EUS‐FNA of regional lymph nodes or the gallbladder (GB) mass itself with 94.8% sensitivity. The overall diagnostic sensitivity rates of ERC and EUS‐FNA were 47.4 and 96%, respectively ( P < 0.001). Post‐procedural complications were seen in 6.7% of the ERC group (4/59, all were mild pancreatitis), and in none of the EUS‐FNA group ( P = 0.10). Conclusions Gallbladder carcinoma sampling using ERC and EUS‐FNA should be incorporated into the diagnostic workup of GB lesions as complementary tools, and EUS‐FNA should be applied in the setting of failed or not indicated ERC.