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Medline ® Abstract for Reference 36

of 'Endoscopic methods for the diagnosis of pancreatobiliary neoplasms'

36
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Comparison between endoscopic brush cytology performed before and after biliary stricture dilation for cancer detection.
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Ornellas LC, Santos Gda C, Nakao FS, Ferrari AP
SO
Arq Gastroenterol. 2006;43(1):20. Epub 2006 May 8.
 
BACKGROUND: Confirmation of malignancy within biliary strictures is endoscopically challenging. Dilation of strictures has been reported to enhance cytological diagnosis.
AIM: To compare brush cytology results before and after biliary stricture dilation.
PATIENTS AND METHODS: Patients with extra-hepatic biliary stricture at endoscopic retrograde cholangiopancreatography were included in the study. Brushing was performed before and immediately after dilation using a 10 Fr dilating catheter. Cytology samples were classified as: negative for malignancy, presence of atypical cells, insufficient material, suspicious for malignancy or positive for malignancy. Final diagnosis was established by surgery, biopsy or follow-up.
RESULTS: Biliary brush cytology was performed in 50 patients, with an overall sensitivity of 40% and 27.5%, before and after dilation, respectively. The combination of results increased cancer detection rate to 45%. Therewere 5/50 (10%) minor complications and one death related to the procedure.
CONCLUSIONS: Brush cytology performed before biliary stricture dilation has a similar cancer detection rate to that following dilation, although the combination of results enhances sensitivity.
AD
Department of Gastroenterology, Federal University of São Paulo, SP, Brazil. lauraornellas@hotmail.com
PMID