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Korean J Gastroenterol  <  Volume 73(4); 2019 <  Articles

Korean J Gastroenterol 2019; 73(4): 213-218  https://doi.org/10.4166/kjg.2019.73.4.213
Comparison of the Diagnostic Performances of Same-session Endoscopic Ultrasound- and Endoscopic Retrograde Cholangiopancreatography-guided Tissue Sampling for Suspected Biliary Strictures at Different Primary Tumor Sites
Seong Jae Yeo1,2, Chang Min Cho1 ,2, Min Kyu Jung1,3, An Na Seo4 and Han Ik Bae4
Department of Internal Medicine, School of Medicine, Kyungpook National University1, Center for Pancreatobiliary Tumors, Kyungpook National University Chilgok Hospital2, Division of Gastroenterology, Kyungpook National University Hospital3, Department of Pathology, School of Medicine, Kyungpook National University4, Daegu, Korea
Correspondence to: Chang Min Cho, Center for Pancreatobiliary Tumors, Kyungpook National University Chilgok Hospital, 807 Hoguk-ro, Buk-gu, Daegu 41404, Korea. Tel: +82-53-200-2608, Fax: +82-53-200-2028, E-mail: cmcho@knu.ac.kr, ORCID: https://orcid.org/0000-0002-9903-1282
Received: December 3, 2018; Revised: February 25, 2019; Accepted: February 27, 2019; Published online: April 25, 2019.
© The Korean Journal of Gastroenterology. All rights reserved.

This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background/Aims: Determining the cause of suspected biliary stricture is often challenging in clinical practice. We aimed to compare the diagnostic yields of endoscopic ultrasound-guided tissue sampling (EUS-TS) and endoscopic retrograde cholangiopancreatography-guided tissue sampling (ERCP-TS) in patients with suspected biliary stricture at different primary lesions.
Methods: We enrolled patients who underwent same-session EUS- and ERCP-TS for the evaluation of suspected biliary stricture. Forceps biopsy and/or brush cytology of intraductal lesions and fine-needle aspiration for solid mass lesions were performed during ERCP and EUS, respectively.
Results: One hundred and twenty-five patients treated at our institution between January 2011 and September 2016, were initially considered for the study. However, 32 patients were excluded due to loss of follow-up (n=8) and ERCP-TS on the pancreatic duct (n=20) or periampullary lesions (n=4). Of the 93 patients included, 86 had a malignant tumor including cholangiocarcinoma (n=39), pancreatic cancer (n=37), and other malignancies (n=10). Seven patients had benign lesions. EUS-TS had higher rate of overall diagnostic accuracy than ERCP-TS (82.8% vs. 60.2%, p=0.001), and this was especially true for patients with a pancreatic lesion (84.4% vs. 51.1%, p=0.003).
Conclusions: EUS-TS was found to be superior to ERCP-TS for evaluating suspected biliary strictures, especially those caused by pancreatic lesions.
Keywords: Endosonography; Cholangiopancreatography, endoscopic retrograde; Diagnosis; Stricture


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