BACKGROUND: Obtaining a definitive tissue diagnosis in patients with hilar biliary strictures (HBS) is often difficult. OBJECTIVE: To describe our experience using a newly developed forward-viewing linear echoendoscope (FVL-EUS) with FNA as a primary diagnostic tool in patients with HBS. DESIGN: Case series. SETTING: A tertiary care, academic medical center. PATIENTS: Four patients with HBS who underwent the procedure. MAIN OUTCOME MEASUREMENTS: Performance of FNA with the FVL-EUS. RESULTS: Visualization and puncture of the primary lesion with a definitive tissue diagnosis was obtained in all of the 4 cases performed. Metastatic hilar cholangiocarcinoma and recurrent neuroendocrine tumor were diagnosed in 2 patients and followed by placement of a self-expandable metal stent, when possible. In the other 2 patients, a diagnosis of resectable hilar cholangiocarcinoma and poorly differentiated adenocarcinoma of unclear origin without evidence of vascular involvement was made, and plastic stents were placed before surgery; the first patient was found to have peritoneal metastases, and resection was aborted, and in the second patient, a gallbladder tumor was diagnosed in the surgical specimen. LIMITATION: The small number of patients. CONCLUSIONS: These preliminary data suggest that FVL-EUS used as a primary tool for the evaluation of patients with HBS may be of value and should be further explored in properly designed studies with a meaningful number of patients.
BACKGROUND: Obtaining a definitive tissue diagnosis in patients with hilar biliary strictures (HBS) is often difficult. OBJECTIVE: To describe our experience using a newly developed forward-viewing linear echoendoscope (FVL-EUS) with FNA as a primary diagnostic tool in patients with HBS. DESIGN: Case series. SETTING: A tertiary care, academic medical center. PATIENTS: Four patients with HBS who underwent the procedure. MAIN OUTCOME MEASUREMENTS: Performance of FNA with the FVL-EUS. RESULTS: Visualization and puncture of the primary lesion with a definitive tissue diagnosis was obtained in all of the 4 cases performed. Metastatic hilar cholangiocarcinoma and recurrent neuroendocrine tumor were diagnosed in 2 patients and followed by placement of a self-expandable metal stent, when possible. In the other 2 patients, a diagnosis of resectable hilar cholangiocarcinoma and poorly differentiated adenocarcinoma of unclear origin without evidence of vascular involvement was made, and plastic stents were placed before surgery; the first patient was found to have peritoneal metastases, and resection was aborted, and in the second patient, a gallbladder tumor was diagnosed in the surgical specimen. LIMITATION: The small number of patients. CONCLUSIONS: These preliminary data suggest that FVL-EUS used as a primary tool for the evaluation of patients with HBS may be of value and should be further explored in properly designed studies with a meaningful number of patients.
Authors: Weon Jin Ko; Ga Won Song; Ki Baik Hahm; Sung Pyo Hong; Joo Young Cho; Jun-Hyung Cho; So Young Jin Journal: Surg Endosc Date: 2016-05-18 Impact factor: 4.584
Authors: Seohyun Lee; Dong Wan Seo; Jun-Ho Choi; Do Hyun Park; Sang Soo Lee; Sung Koo Lee; Myung-Hwan Kim Journal: Gut Liver Date: 2015-09-23 Impact factor: 4.519