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Copyright ©The Author(s) 2022.
World J Gastrointest Endosc. May 16, 2022; 14(5): 291-301
Published online May 16, 2022. doi: 10.4253/wjge.v14.i5.291
Table 1 Tools for endobiliary biopsy sampling
Endoscopic techniques
Advantage Disadvantage
ERC + TPBSafeness, feasibility and large availability; better sensibility for MBS versus brushingLow sensitivity for MBS (48%), difficulty of cannulation with standard biopsy forceps, not easy targeting of the lesion
ERC + TPB with C-BFSlight better sensibility (60%) for MBS respect to conventional biopsy forcepsSampling benefits limited to lesions located to the right intrahepatic bile duct (75%)
Cholangioscopy + endobiliary biopsyGain in accuracy for diagnosis of malignancy in indeterminate lesions (85-92%) versus ERCP + TPBSame safety; issue with direct cholangioscopy related to rare adv events (leakege of air in to portal vein)
IDUS + TPBHigher sensitivity for malignancy in indeterminate intraductal lesiones (87-91%) versus ERCP + TPB Advanced experience in both ERCP/EUS requested, lack of standardized procedure and specific devices, time-consuming technique
Interventional radiology techniques
AdvantageDisadvantage
PTE endobiliary brushingSafe, cheap and large availability; Low sensitivity for MBS
PTE endobiliary biopsyHigh sensitivity; Larger biopsy cup comapred to ERC + TPBIndirect visualization of the lesion
Colangioscopy + PTEFBDirect visualization of the lesion; Combined procedure with endoscopist; Expensive procedure; small size specimen