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CC BY 4.0 · Endoscopy
DOI: 10.1055/a-2728-8013
Innovations and brief communications

Intraductal Cryobiopsy via Percutaneous Cholangioscopy for Biliary Strictures: a Multicenter Feasibility Study

Authors

  • Jan Peveling-Oberhag

    1   Gastroenterology, Gastrointestinal Oncology, Hepatology and Infectious Diseases, Klinikum Stuttgart, Stuttgart, Germany (Ringgold ID: RIN14881)

  • Christian Gerges 

    2   Clinic for Gastroenterology, Hepatology and Transplant Medicine, University Hospital Essen, Essen, Germany
    3   Internal Medicine II, Gastroenterology, Hepatology, Interventional Endoscopy, Infectiology, Health and Medical University, Campus Helios Clinic Krefeld, Krefeld, Germany

  • Jörg Albert

    1   Gastroenterology, Gastrointestinal Oncology, Hepatology and Infectious Diseases, Klinikum Stuttgart, Stuttgart, Germany (Ringgold ID: RIN14881)

  • Lukas Welsch

    4   Department of Gastroenterology, Diabetology and Infectiology, Klinikum Hanau gGmbH, Hanau, Germany (Ringgold ID: RIN39790)

  • Philip Grunert

    5   Clinic for Gastroenterology, Hepatology and Transplant Medicine, University Hospital Essen, Essen, Germany (Ringgold ID: RIN39081)

  • Gilbert Rahe

    2   Clinic for Gastroenterology, Hepatology and Transplant Medicine, University Hospital Essen, Essen, Germany

  • Alexander Dechene

    6   Gastroenterologie, Klinikum Nürnberg, Nurnberg, Germany (Ringgold ID: RIN9211)

  • Axel Eickhoff

    7   Klinik für Gastroenterologie, Klinikum Hanau gGmbH, Hanau, Germany (Ringgold ID: RIN39790)

  • Matthias Dettmer

    8   Institute for Pathology, Klinikum Stuttgart, Stuttgart, Germany (Ringgold ID: RIN14881)

  • Walter Linzenbold

    9   Research Department, Erbe Elektromedizin GmbH, Tübingen, Germany (Ringgold ID: RIN27657)

  • Markus Enderle

    10   Research Department, ERBE Elektromedizin GmbH, Tubingen, Germany (Ringgold ID: RIN27657)

  • Thomas Rösch 

    11   Klinik und Poliklinik für Interdisziplinäre Endoskopie, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany

  • Katharina Zimmermann-Fraedrich

    12   Klinik und Poliklinik für Interdisziplinäre Endoskopie, Universitatsklinikum Hamburg-Eppendorf, Hamburg, Germany (Ringgold ID: RIN37734)

Supported by: Erbe Comp Tübingen unrestricted greant for study personnel

Clinical Trial:

Registration number (trial ID): NCT06249841, Trial registry: ClinicalTrials.gov (http://www.clinicaltrials.gov/), Type of Study: prospective


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Background and study aims: Tissue diagnosis of biliary strictures is challenging and often requires multiple methods. Cryobiopsy, well established in bronchoscopy for high tissue yield, is presented here for the first time as a proof-of-principle feasibility study via the percutaneous route in biliary strictures. Patients and Methods: Patients undergoing percutaneous cholangioscopy for intraductal diagnoses of biliary strictures received 6 forceps biopsies and 3 cryobiopsies in randomized order. The main objective was feasibility, defined as retrieval of at least one adequate sample per method per patient. Results: In 15 patients (53% male, mean age 60.2 years), all had at least one adequate sample from both methods. Cryobiopsy yielded significantly larger (8.54 mm² vs. 1.87 mm²; p<0.0001) and more representative specimens (97.6% vs. 74.7%; p=0.001). It also scored higher on overall histologic quality (Likert 0–6: 5 vs. 4; p=0.0005) and had fewer artifacts (95% vs. 85.5%; p=0.011). No bleeding or perforations occurred; only minor adverse events were reported and resolved with standard treatment. Conclusions: This feasibility study showed that intraductal cryobiopsy via percutaneous cholangioscopy yielded larger samples and may enable more detailed histologic assessment than forceps biopsies. Further studies will evaluate its accuracy, safety, and potential for use with peroral cholangioscopy during ERCP.



Publication History

Received: 25 March 2025

Accepted after revision: 27 September 2025

Accepted Manuscript online:
22 October 2025

© . The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/).

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