caa a22 4500 445888121 CHVBK 20180317145606.0 cr unu---uuuuu 170323e20110701xx s 000 0 eng 10.1007/s00535-011-0404-z doi (NATIONALLICENCE)springer-10.1007/s00535-011-0404-z EUS-FNA for suspected malignant biliary strictures after negative endoscopic transpapillary brush cytology and forceps biopsy [Elektronische Daten] [Yasuhiro Ohshima, Ichiro Yasuda, Hiroshi Kawakami, Masaki Kuwatani, Tsuyoshi Mukai, Takuji Iwashita, Shinpei Doi, Masanori Nakashima, Yoshinobu Hirose, Masahiro Asaka, Hisataka Moriwaki] Background: Endoscopic transpapillary brush cytology and forceps biopsy are widely used for the pathological diagnosis of suspected malignant biliary strictures (MBS). However, the sensitivity of these methods remains insufficient, and it can be difficult to confirm the diagnosis. We aimed to evaluate the diagnostic ability of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) and the impact of this technique on clinical management in patients with suspected MBS where endoscopic brush cytology and biopsy yielded negative results. Methods: This study included 225 consecutive patients with suspected MBS, who underwent endoscopic brush cytology and biopsy at our institutions. Negative results were obtained for these pathological tests in 75 patients, and EUS-FNA was performed in 22 of these patients. We retrospectively compared the EUS-FNA results with the final diagnosis and examined the influence of the EUS-FNA diagnosis on treatment selection. Results: FNA specimens were successfully obtained in all patients, and the pathological results confirmed malignancy in 16 cases and predicted that the other 6 cases were benign. Of the 6 cases that were suspected to be benign, 3 patients were diagnosed with xanthogranulomatous cholecystitis by surgical pathology, and the remaining 3 patients were diagnosed with benign diseases at a follow-up after 12-18months. Thus, the EUS-FNA-based diagnosis was proven correct for all the patients. In addition, the treatment strategy was altered as a result of the EUS-FNA results in the above 6 patients (27%). Conclusions: EUS-FNA is a sensitive and safe diagnostic modality for patients with suspected MBS and can be an additional option in cases where endoscopic brush cytology and biopsy have produced negative results. Springer, 2011 EUS-FNA nationallicence Biliary stricture nationallicence Bile duct cancer nationallicence Gallbladder cancer nationallicence Xanthogranulomatous cholecystitis nationallicence Ohshima Yasuhiro First Department of Internal Medicine, Gifu University Hospital, 1-1 Yanagido, 501-1194, Gifu, Japan aut Yasuda Ichiro First Department of Internal Medicine, Gifu University Hospital, 1-1 Yanagido, 501-1194, Gifu, Japan aut Kawakami Hiroshi Department of Gastroenterology, Hokkaido University Hospital, Sapporo, Japan aut Kuwatani Masaki Department of Gastroenterology, Hokkaido University Hospital, Sapporo, Japan aut Mukai Tsuyoshi First Department of Internal Medicine, Gifu University Hospital, 1-1 Yanagido, 501-1194, Gifu, Japan aut Iwashita Takuji First Department of Internal Medicine, Gifu University Hospital, 1-1 Yanagido, 501-1194, Gifu, Japan aut Doi Shinpei First Department of Internal Medicine, Gifu University Hospital, 1-1 Yanagido, 501-1194, Gifu, Japan aut Nakashima Masanori First Department of Internal Medicine, Gifu University Hospital, 1-1 Yanagido, 501-1194, Gifu, Japan aut Hirose Yoshinobu Department of Clinical Pathology, Gifu University Hospital, Gifu, Japan aut Asaka Masahiro Department of Gastroenterology, Hokkaido University Hospital, Sapporo, Japan aut Moriwaki Hisataka First Department of Internal Medicine, Gifu University Hospital, 1-1 Yanagido, 501-1194, Gifu, Japan aut Journal of Gastroenterology Springer Japan 46/7(2011-07-01), 921-928 0944-1174 46:7<921 2011 46 535 https://doi.org/10.1007/s00535-011-0404-z text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00535-011-0404-z text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Ohshima Yasuhiro First Department of Internal Medicine, Gifu University Hospital, 1-1 Yanagido, 501-1194, Gifu, Japan aut NATIONALLICENCE 700 1- Yasuda Ichiro First Department of Internal Medicine, Gifu University Hospital, 1-1 Yanagido, 501-1194, Gifu, Japan aut NATIONALLICENCE 700 1- Kawakami Hiroshi Department of Gastroenterology, Hokkaido University Hospital, Sapporo, Japan aut NATIONALLICENCE 700 1- Kuwatani Masaki Department of Gastroenterology, Hokkaido University Hospital, Sapporo, Japan aut NATIONALLICENCE 700 1- Mukai Tsuyoshi First Department of Internal Medicine, Gifu University Hospital, 1-1 Yanagido, 501-1194, Gifu, Japan aut NATIONALLICENCE 700 1- Iwashita Takuji First Department of Internal Medicine, Gifu University Hospital, 1-1 Yanagido, 501-1194, Gifu, Japan aut NATIONALLICENCE 700 1- Doi Shinpei First Department of Internal Medicine, Gifu University Hospital, 1-1 Yanagido, 501-1194, Gifu, Japan aut NATIONALLICENCE 700 1- Nakashima Masanori First Department of Internal Medicine, Gifu University Hospital, 1-1 Yanagido, 501-1194, Gifu, Japan aut NATIONALLICENCE 700 1- Hirose Yoshinobu Department of Clinical Pathology, Gifu University Hospital, Gifu, Japan aut NATIONALLICENCE 700 1- Asaka Masahiro Department of Gastroenterology, Hokkaido University Hospital, Sapporo, Japan aut NATIONALLICENCE 700 1- Moriwaki Hisataka First Department of Internal Medicine, Gifu University Hospital, 1-1 Yanagido, 501-1194, Gifu, Japan aut NATIONALLICENCE 773 0- Journal of Gastroenterology Springer Japan 46/7(2011-07-01), 921-928 0944-1174 46:7<921 2011 46 535 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer