T-F Li1, K-W Ren1, X-W Han2, W-C Li3, J-L Ren4, D-C Jiao1, Z Li1, J Ma1. 1. Department of Radiology, The First Affiliated Hospital of Zhengzhou University, PR China; Interventional Institute of Zhengzhou University, PR China; Interventional Treatment and Clinical Research Center of Henan Province, PR China. 2. Department of Radiology, The First Affiliated Hospital of Zhengzhou University, PR China; Interventional Institute of Zhengzhou University, PR China; Interventional Treatment and Clinical Research Center of Henan Province, PR China. Electronic address: hanxinwei2006@163.com. 3. Department Pathology, The First Affiliated Hospital of Zhengzhou University, PR China. 4. Department of Pathology, The Second Affiliated Hospital of Zhengzhou University, Zhengzhou, PR China.
Abstract
AIM: To investigate the feasibility and advantages of cholangiobiopsy during percutaneous transhepatic cholangiography in the histopathological diagnosis of anastomotic stenosis after cholangiojejunostomy for malignant obstructive jaundice. MATERIALS AND METHODS: Using biopsy forceps, specimens were collected from the site of stenosis in patients with recurrent jaundice (n = 24) who had previously undergone cholangiojejunostomy for malignant obstructive jaundice. RESULTS: Stenosis occurred in all patients at the biliary-enteric anastomosis based on percutaneous transhepatic cholangiography, and was the location of the biopsy. Satisfactory specimens were obtained from 22 out of 24 patients. The sensitivity was 91.7% (22/24). Tumour tissue was obtained in 18 cases, confirming disease recurrence. Histopathological changes in four patients were diagnosed as fibroplasia and/or inflammation. These were considered cicatricial stenoses based on histopathological, imaging, and laboratory findings. The remaining two histopathology-negative patients were proven to have recurrent tumour based on imaging, laboratory, and follow-up data. No complications occurred during biopsy, including gastrointestinal haemorrhage or perforation. Either cholangial drainage and/or an inner stent was used following biopsy, which resulted in a noticeable decrease in jaundice postoperatively (p < 0.05). CONCLUSION: Percutaneous transhepatic cholangiobiopsy using biopsy forceps for the diagnosis of anastomotic stenosis after cholangiojejunostomy for malignant biliary obstructive jaundice is easy to perform and safe, with a high level of sensitivity. Interventional therapies, such as percutaneous transhepatic cholangial drainage and stent placement, can be performed concurrently, markedly improving the symptoms of patients with obstructive jaundice.
AIM: To investigate the feasibility and advantages of cholangiobiopsy during percutaneous transhepatic cholangiography in the histopathological diagnosis of anastomotic stenosis after cholangiojejunostomy for malignant obstructive jaundice. MATERIALS AND METHODS: Using biopsy forceps, specimens were collected from the site of stenosis in patients with recurrent jaundice (n = 24) who had previously undergone cholangiojejunostomy for malignant obstructive jaundice. RESULTS:Stenosis occurred in all patients at the biliary-enteric anastomosis based on percutaneous transhepatic cholangiography, and was the location of the biopsy. Satisfactory specimens were obtained from 22 out of 24 patients. The sensitivity was 91.7% (22/24). Tumour tissue was obtained in 18 cases, confirming disease recurrence. Histopathological changes in four patients were diagnosed as fibroplasia and/or inflammation. These were considered cicatricial stenoses based on histopathological, imaging, and laboratory findings. The remaining two histopathology-negative patients were proven to have recurrent tumour based on imaging, laboratory, and follow-up data. No complications occurred during biopsy, including gastrointestinal haemorrhage or perforation. Either cholangial drainage and/or an inner stent was used following biopsy, which resulted in a noticeable decrease in jaundice postoperatively (p < 0.05). CONCLUSION: Percutaneous transhepatic cholangiobiopsy using biopsy forceps for the diagnosis of anastomotic stenosis after cholangiojejunostomy for malignant biliary obstructive jaundice is easy to perform and safe, with a high level of sensitivity. Interventional therapies, such as percutaneous transhepatic cholangial drainage and stent placement, can be performed concurrently, markedly improving the symptoms of patients with obstructive jaundice.
Authors: Anne Marie Augustin; Marcus Steingrüber; Friederika Fluck; Oliver Goetze; Thorsten Alexander Bley; Ralph Kickuth Journal: Diagn Interv Radiol Date: 2020-07 Impact factor: 2.630
Authors: Aldo Sebastián Oggero; Florencia Di Rocco; Pablo Ezequiel Huespe; Eduardo Mullen; Martín de Santibañes; Rodrigo Sanchez Claria; Oscar María Mazza; Juan Pekolk; Eduardo de Santibañes; Sung Ho Hyon Journal: Cardiovasc Intervent Radiol Date: 2021-05-04 Impact factor: 2.740