Abstract
Introduction The ideal endoscopic retrograde cholangiopancreatography (ERCP) tissue sampling technique
should be simple, inexpensive, and yield sufficient tissue for histology while permitting
contrast-guided targeting under fluorescence and multiple passes into the bile duct.
Current techniques do not fulfill these requirements comprehensively. We designed
a catheter for optimized targeting of large intrabiliary biopsies.
Methods A 3.5-mm sterile, single-use prototype catheter was developed, with three independent
lumina extending continuously to the distal tip for three distinct functions to be
available simultaneously: passage of large volume biopsy forceps (1.8 mm), wire guidance
(0.035″), and contrast injection.
Results First clinical use in five patients (four transpapillary, one percutaneous access)
allowed good intrabiliary manipulation in 4/5 patients. Contrast-guided sampling provided
adequate specimens. No adverse events were noted.
Discussion Technical aspects and preliminary clinical data for the novel triple lumen biopsy
catheter are encouraging. The catheter allowed wire guidance and contrast application
to guide sampling of larger pieces of tissue. In perspective, the working channel
could host any accessory for targeted intrabiliary diagnosis and therapy, and catheter
use is not limited to bile ducts.
