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C-2583 - Percutaneous transhepatic intraductal biopsy in biliary stricture differentiation

D. Frantsev, O. N. Sergeeva, M. A. Shorikov, E. Virshke, V. Panov, E. Moroz, O. Chistyakova, B. Dolgushin; Moscow/RU Type: Scientific Exhibit
Area of Interests: Abdomen, Oncology, Interventional non-vascular
Imaging Techniques: Percutaneous, MR
Procedures: Cholangiography, Biopsy
Special Focuses: Cancer, Inflammation
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Aims and objectives: The majority of biliary strictures are attributed to malignancy, but there is a group of benign ductal lesions resembling cholangiocarcinoma called pseudo-Klatskin tumor, Klatskin-mimicking lesions or malignant masquerade [1, 2]. It includes primary sclerosing cholangitis, IgG4-sclerosing cholangiop[...]

Methods and materials: Since 2007 224 patients have undergone percutaneous transhepatic biliary drainage (PTBD) for obstructive jaundice caused by biliary strictures without evident periductal mass lesion Fig. 2. PTIB was performed in 162 out of 224 patients. Special biopsy devices (brush and forceps) were delivered to bi[...]

Results: The majority of patients demonstrated neoplastic biliary strictures (152 out of 162 patients, 93.8%). Pathologist findings consistent with malignancy were obtained in 86% of cytological and 67% of histologic samples. Two biopsy attempts had significantly better diagnostic accuracy (p<0.0001) comp[...]

Conclusion: Biliary neoplastic–mimicking lesions still remain diagnostical dilemma frequently require unnecessary surgery. PTIB is easy and effective intervention differentiating benign and malignant biliary strictures without surgical exploration.

Personal information: D.Frantsev1, O.Sergeeva1, M. Shorikov2, E.Virshke1, V. Panov2, E.Moroz3, O.Chistyakova3, B.Dolgushin1   1N.N.Blokhin Cancer Research Center, Interventional Oncology department, Moscow/RU, 2N.N.Blokhin Cancer Research Center, Radiology department, Moscow/RU, 3N.N.Blokhin Cancer Research Center, [...]

References: Hadjis N.S., Collier N.A., Blumgart L.H. Malignant masquerade at the hilum of the liver. Br. J. Surg. 1985; 72 (8): 659–661.  Knoefel W.T., Prenzel K.L., Peiper M, Hosch S.B., Gundlach M., Eisenberger C.F., Strate T., Scheunemann P., Rogiers X., Izbicki J.R. Klatskin tumors and Klatskin mi[...]

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