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CC BY-NC-ND 4.0 · Endosc Int Open 2022; 10(06): E809-E814
DOI: 10.1055/a-1797-8966
Original article

A new tool for bile duct tissue sampling: ex vivo clinical evaluation of intraductal cryobiopsy for cholangioscopy

Lukas Wirsing
1   Department of Gastroenterology, Hepatology and Endocrinology, Robert-Bosch-Hospital, Stuttgart, Germany
,
Walter Linzenbold
2   ERBE Elektromedizin GmbH, Tuebingen, Germany
,
Simon U. Jaeger
3   Department of Clinical Pharmacology, University Hospital, University of Tuebingen, Tuebingen, Germany
4   Dr. Margarete Fischer-Bosch-Institute of Clinical Pharmacology (IKP), Stuttgart, Germany
,
Phillip Stahl
5   Department of Clinical Pathology, Robert-Bosch-Hospital, Stuttgart, Germany
,
German Ott
5   Department of Clinical Pathology, Robert-Bosch-Hospital, Stuttgart, Germany
,
Tobias Leibold
6   Department of Surgery, Robert-Bosch-Hospital, Stuttgart, Germany
,
Markus Enderle
2   ERBE Elektromedizin GmbH, Tuebingen, Germany
,
Jörg Albert
1   Department of Gastroenterology, Hepatology and Endocrinology, Robert-Bosch-Hospital, Stuttgart, Germany
,
Jan Peveling-Oberhag
1   Department of Gastroenterology, Hepatology and Endocrinology, Robert-Bosch-Hospital, Stuttgart, Germany
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Abstract

Background and study aims Indeterminate biliary strictures represent a major challenge in clinical diagnostics. Diagnostic yield of radiological, endoscopic imaging and histopathological diagnosis is insufficient. The cryobiopsy technique is a new method for tissue extraction already used in different clinical settings. The aim of this ex vivo clinical study was to investigate feasibility and tissue quality of cryobiopsy in the bile duct.

Patients and methods We included 14 patients who underwent pancreaticoduodenectomy. Bile duct samples were taken with either a new prototype cryoprobe or one of two forceps types. Results were analyzed for general feasibility, specimen size, histological assessability as well as representativity of retrieved tissue.

Results Feasibility of cholangioscopic forceps was poor compared to gastric biopsy forceps or cryobiopsy. Significantly larger tissue samples were obtained with cryobiopsy (5.6 ± 4.5 mm2) compared to gastric biopsy forceps (3.3 ± 5.1 mm2, P = 0.006). Furthermore, cryobiopsy was superior in histological assessment quality (P = 0.02) and concerning representativity (P = 0.03).

Conclusions Cryobiopsy in the bile duct is feasible and the quality of the obtained tissue is high. Further investigation of bile duct cryobiopsy in vivo is warranted.

Supplementary material



Publication History

Received: 29 September 2021

Accepted after revision: 03 March 2022

Article published online:
10 June 2022

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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