Endoscopic retrograde brush cytology (ERBC) of the biliary and pancreatic ducts.

A new device with a brushing tube that can be introduced through the biopsy channel of the duodenoscope (Olympus JF B) used for cannulation of the papilla of Vater is reported. In 17 patients in whom ERCP had demonstrated ductal abnormalities, an endoscopic retrograde brush cytology (ERBC) was performed. A cytological diagnosis of malignancy was made in 8 patients and a possible malignancy in 2 cases. Seven cases were operated upon, and a malignant tumor was found in 6. In one case a malignant tumor was found at autopsy. Histological examination was performed in 6 cases and showed adenocarcinoma in all.. Two patients with malignant cells and ERCP-findings of suspected pancreatic carcinoma were not operated upon. The tumours were localized in 1 case to the papilla of Vater, in 2 to the biliary duct, in 4 to the pancreatic head, and in 2 cases to the pancreatic corpus. No complications occured. It is concluded that this technique provides information supplementary to that of other diagnostic procedures.