Endoscopy 2020; 52(S 01): S308
DOI: 10.1055/s-0040-1704989
ESGE Days 2020 ePoster presentations
Thursday, April 23, 2020 09:00 – 17:00 Endoscopic ultrasound ePoster area
© Georg Thieme Verlag KG Stuttgart · New York

EUS-FNA AND ERCP IN THE PRESURGICAL DIAGNOSIS OF MALIGNANT BILIARY STENOSIS: PRELIMINARY RESULTS OF A COMPARATIVE STUDY

CM Gesuale
1   University Tor Vergata, Gastroenterology Unit, Department of Medicine Systems, Rome, Italy
,
E Grasso
1   University Tor Vergata, Gastroenterology Unit, Department of Medicine Systems, Rome, Italy
,
E Troncone
1   University Tor Vergata, Gastroenterology Unit, Department of Medicine Systems, Rome, Italy
,
OA Paoluzi
1   University Tor Vergata, Gastroenterology Unit, Department of Medicine Systems, Rome, Italy
,
A Anselmo
2   University Tor Vergata, HPB and Transplant Unit, Department of Surgery, Rome, Italy
,
T Manzia
2   University Tor Vergata, HPB and Transplant Unit, Department of Surgery, Rome, Italy
,
G Tisone
2   University Tor Vergata, HPB and Transplant Unit, Department of Surgery, Rome, Italy
,
G Monteleone
1   University Tor Vergata, Gastroenterology Unit, Department of Medicine Systems, Rome, Italy
,
GDV Blanco
1   University Tor Vergata, Gastroenterology Unit, Department of Medicine Systems, Rome, Italy
› Author Affiliations
Further Information

Publication History

Publication Date:
23 April 2020 (online)

Also available at
 

Aims Endoscopic ultrasonography (EUS) with fine needle aspiration (EUS-FNA) has been proposed in addition to cholangiopancreatography (ERCP) for tissue sampling in the diagnosis of a malignant from non-malignant biliary stenosis. Aim of the study was to evaluate the diagnostic power of EUS-FNA alone and in combination with ERCP in biliary stenosis.

Methods 134 patients, hospitalized for jaundice, underwent EUS plus CT scan or MRI. Tissue sampling by EUS-FNA and/or brushing-forceps biopsy during ERCP was performed if a cholangiocarcinoma (CCA) was suspected. Final diagnosis was defined based on histopathology of surgical specimen or outcome at follow-up.

Results 56 patients (42%) underwent EUS plus MRI, 42 (32%) EUS plus CT scan, and 36 (26%) EUS plus CT scan plus MRI. ERCP was performed in 65 patients, in 16/65 EUS-FNA and ERCP were carried out in a same session. A biliary stenosis was diagnosed in 19 patients, which was a CCA in 13 (10%) and a benign condition in 6. The remaining 115 patients had a non-stenosing benign condition. EUS findings were diagnostic in 11/13 patients with CCA. Sensitivity, specificity and diagnostic accuracy in CCA were: 85%, 97% and 95% for EUS-FNA alone; 82%, 100% and 88% for EUS-FNA plus ERCP forceps biopsy and brushing.

Conclusions EUS shows a high diagnostic accuracy in diagnosing malignant and non-malignant biliary stenosis. The possibility to perform EUS-FNA for tissue acquisition in a same session of ERCP may increase the diagnostic accuracy and reduce the time for diagnosis.