Endoscopy 2023; 55(S 02): S150
DOI: 10.1055/s-0043-1765372
Abstracts | ESGE Days 2023
ePoster

Different biopsies handling protocols in digital single-operator cholangioscopy for indeterminate biliary strictures: a retrospective analysis of a single tertiary center

V. G. Mirante
1   AUSL Reggio Emilia, Reggio Emilia, Italy
,
A. Cippitelli
1   AUSL Reggio Emilia, Reggio Emilia, Italy
,
G. Carlinfante
1   AUSL Reggio Emilia, Reggio Emilia, Italy
,
C. Cardamone
1   AUSL Reggio Emilia, Reggio Emilia, Italy
,
S. Grillo
1   AUSL Reggio Emilia, Reggio Emilia, Italy
,
G. Sereni
1   AUSL Reggio Emilia, Reggio Emilia, Italy
,
V. Iori
1   AUSL Reggio Emilia, Reggio Emilia, Italy
,
R. Sassatelli
1   AUSL Reggio Emilia, Reggio Emilia, Italy
› Author Affiliations
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Aims Indeterminate biliary strictures (IDBS) represents a diagnostic challenge. Digital single-operator cholangioscopy (D-SOC) allows biopsies of biliary lesions under direct visualization [1]. However, the diagnostic yield of D-SOC is still suboptimal [2], and the optimal specimen processing technique remains unclear. In our analysis, we retrospectively compared three different tissue processing methods to determine the optimal strategy ([Table 1]).

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Table 1

Methods All 57 consecutive patients who underwent 70 D-SOC biopsies for IDBS between May 2017 and June 2022 were considered. Three were the biopsy handling protocols for off-side evaluation: in protocol 1, at least 6 biopsies were collected in a single container with 10% buffered formalin solution for fixation; in protocol 2, at least 5 biopsies were oriented on cellulose acetate filter and all were collected in a single container; and in protocol 3, at least 5 biopsies were individually oriented on cellulose acetate filter and each placed in its own separate container. For each protocol, the number of biopsies missed and the percentage of specimens judged adequate for subsequent pathologist evaluation were calculated.

Results In 10 patients of the first group one or more specimens were lost, accounting for a total of 37 % of the biopsies. This percentage was significantly lower with the second protocol (6%) and really low in the last group (0.7%). Protocol 3 was also better than protocol 2 in adequacy of specimens to the pathologist's assessment.

Conclusions To separate specimens individually reduces the number of biopsies missed and appears to increase the adequacy of the sample obtained during D-SOC for IDBS.



Publication History

Article published online:
14 April 2023

© 2023. European Society of Gastrointestinal Endoscopy. All rights reserved.

Georg Thieme Verlag KG
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  • 1 SpyGlass AMEA Registry Group. Almadi MA, Itoi T, Moon JH, Goenka MK, Seo DW, Rerknimitr R, Lau JY, Maydeo AP, Lee JK, Nguyen NQ, Niaz SK, Sud R, Ang TL, Aljebreen A, Devereaux BM, Kochhar R, Reichenberger J, Yasuda I, Kaffes AJ, Kitano M, Peetermans J, Goswamy PG, Rousseau MJ, Reddy DN, Lakhtakia S, Lee YN, Rai VK, Kamada K, Tanaka R, Tonozuka R, Tsuchida A, Song TJ, Ramchandani MK. Using single-operator cholangioscopy for endoscopic evaluation of indeterminate biliary strictures: results from a large multinational registry. Endoscopy 2020; 52 (07) 574-582 Epub 2020 Apr 14 PMID: 32289852
    Thieme ConnectPubMedSearch in Google Scholar
  • 2 de Vries AB, van der Heide F, Ter Steege RWF, Koornstra JJ, Buddingh KT, Gouw ASH, Weersma RK.. Limited diagnostic accuracy and clinical impact of single-operator peroral cholangioscopy for indeterminate biliary strictures. Endoscopy 2020; 52 (02) 107-114 Epub 2019 Dec 13 PMID: 31858509
    Thieme ConnectPubMedSearch in Google Scholar