Aims Indeterminate biliary strictures (IBS) represent a major challenge in clinical diagnostics
today. Diagnostic yield of radiological and endoscopic imaging is insufficient, and
histopathological diagnosis based on in-vivo biopsy technique is ambiguous in many
cases. The cryobiopsy technique (CB) is a new method for tissue extraction, which
is already used for endobronchial biopsies in clinical routine.
The aim of this ex-vivo clinical study was to investigate feasibility and tissue quality
of CB in comparison to standard biopsy forceps for the retrieval of native and pathologically
altered bile duct tissue.
Methods We included 14 patients with suspected tumor obstruction of the common bile duct
who underwent pancreaticoduodenectomy. Tissue samples were taken from either visibly
altered areas or native bile duct. A new prototype of a cryoprobe as well as standard
forceps (cholangioscopic forceps CF or gastric biopsy forceps GBF) were used for comparison.
All biopsy specimens were assessed by two pathologists blinded to the biopsy method.
Data was collected and analyzed for general feasibility, specimen area, and histological
assessability as well as representativity of tissue.
Results CB success rate was superior to CF (p=0.0022). There was no statistical difference
between CB and GBF concerning feasibility (p=0.2096). Significantly larger tissue
samples were obtained with CB compared to GBF (p=0.005). CB was superior in histological
assessment quality compared to pooled forceps (p=0.0302) and concerning representativity
(p=0.0225).
Conclusions CB in the bile duct is feasible and the quality of the obtained tissue is high. Larger
tissue amounts and more representative samples can be retrieved than with a standard
biopsy forceps. With these promising results, an in-vivo study should be initiated.
Citation: Wirsing L, Linzenbold W, Enderle M et al. OP134 A NEW TOOL FOR BILE DUCT TISSUE SAMPLING:
EX-VIVO CLINICAL EVALUATION OF INTRADUCTAL CRYOBIOPSY FOR CHOLANGIOSCOPY. Endoscopy
2021; 53: S55.
