Efficacy of SpyGlassTM-directed biopsy compared to brush cytology in obtaining adequate tissue for diagnosis in patients with biliary strictures

doi:10.4253/wjge.v6.i4.137

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World Journal of Gastrointestinal Endoscopy

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1948-5190

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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World J Gastrointest Endosc. Apr 16, 2014; 6(4): 137-143
Published online Apr 16, 2014. doi: 10.4253/wjge.v6.i4.137

Efficacy of SpyGlass^TM-directed biopsy compared to brush cytology in obtaining adequate tissue for diagnosis in patients with biliary strictures

Johannes Wilhelm Rey, Torsten Hansen, Sebastian Dümcke, Achim Tresch, Katja Kramer, Peter Robert Galle, Martin Goetz, Marcus Schuchmann, Ralf Kiesslich, Arthur Hoffman

Johannes Wilhelm Rey, Katja Kramer, Peter Robert Galle, Martin Goetz, Marcus Schuchmann, Ralf Kiesslich, Arthur Hoffman, Department of Internal Medicine I, University Medical Center, 55131 Mainz, Germany

Johannes Wilhelm Rey, Ralf Kiesslich, Arthur Hoffman, Department of Internal Medicine, St. Mary’s Hospital, 60318 Frankfurt, Germany

Torsten Hansen, Institute of Pathology, Klinikum Lippe GmbH, 32657 Detmold, Germany

Sebastian Dümcke, Achim Tresch, Max Planck-Institute for Plant Breeding Research, 50829 Köln, Germany

Sebastian Dümcke, Achim Tresch, Institute for Genetics, University of Cologne, 50931 Köln, Germany

Martin Goetz, Department of Internal Medicine I, University Hospital of Tuebingen, 72076 Tübingen, Germany

Author contributions: Galle PR, Kiesslich R and Hoffman A designed the research; Rey JW, Katja Kramer, Goetz M, Schuchmann M, Hoffman A and Kiesslich R performed the research; Hansen T provided the histologic results; Dümcke S and Tresch A analyzed the data; Rey JW and Hoffman A wrote the manuscript.

Correspondence to: Arthur Hoffman, MD, PhD, Department of Internal Medicine, St. Mary´s Hospital Frankfurt, Richard-Wagner-Straße 14, 60318 Frankfurt, Germany. ahoff66286@aol.com

Telephone: +49-151-11628399 Fax:+49-69-15631577

Received: December 30, 2013
Revised: March 4, 2014
Accepted: March 11, 2014
Published online: April 16, 2014

Core Tip

Core tip: Endoscopic retrograde cholangiography remains the gold standard method for diagnosing biliary tract diseases. However, choledochoscopy with the SpyGlass^TM system enables direct visualization of the biliary tract. Furthermore, targeted biopsies can be performed. In our single-center study, the diagnostic yield of SpyGlass^TM-directed biopsy for inflammatory changes in primary sclerosing cholangitis (PSC) and non-PSC patients was significantly greater than that of brush cytology. The better diagnostic yield strongly correlated with significantly greater amounts of tissue for histological evaluation.