Medline ® Abstract for Reference 68
Evaluation of hilar biliary strictures by using a newly developed forward-viewing therapeutic echoendoscope: preliminary results of an ongoing experience.
Larghi A, Lecca PG, Ardito F, Rossi ED, Fadda G, Nuzzo G, Costamagna G
Gastrointest Endosc. 2009;69(2):356.
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.
Digestive Endoscopy Unit, Catholic University, Rome, Italy.