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Endoscopy 2010; 42(10): 837-841
DOI: 10.1055/s-0030-1255633
Original article

© Georg Thieme Verlag KG Stuttgart · New York

Usefulness of endoscopic retrograde biliary biopsy using large-capacity forceps for extrahepatic biliary strictures: a prospective randomized study

M.  Ikeda1 , I.  Maetani1 , K.  Terada2 , T.  Ukita1 , T.  Tada1 , H.  Shigoka1 , S.  Omuta1 , K.  Takahashi3
  • 1Division of Gastroenterology, Department of Internal Medicine, Toho University Ohashi Medical Center, Tokyo, Japan
  • 2Department of Medical Informatics, Faculty of Medicine, Toho University, Tokyo, Japan
  • 3Department of Surgical Pathology, Toho University Ohashi Medical Center, Tokyo, Japan
Further Information

Publication History

submitted 25 March 2009

accepted after revision 11 June 2010

Publication Date:
30 September 2010 (online)

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Commentaire de travail de M. Ikeda et al., pp. 837Endoscopy 2010; 42(10): 883-883
DOI: 10.1055/s-0032-1306700

Background and study aims: Endoscopic retrograde biliary biopsy samples are frequently too small and inadequate, which makes histological interpretation difficult. We therefore evaluated the diagnostic usefulness of forceps with a larger-sized cup and compared this with standard forceps for biliary biopsy.

Patients and methods: This prospective study included consecutive patients with extrahepatic biliary strictures who underwent retrograde biliary biopsy between March 2005 and March 2006 at the Toho University Ohashi Medical Center. The standard forceps used were 1.8-mm forceps (FB-39Q, Olympus, Tokyo, Japan) and the large-capacity forceps were 2.2-mm forceps (Radial jaw3, Boston Scientific Inc., Natick, Massachusetts, USA). Four randomized biopsy specimens were taken from each patient, two using each type of forceps.

Results: A total of 32 patients (30 with malignant biliary strictures and 2 with benign biliary strictures) were enrolled. The median size of the biopsy samples taken using the standard forceps was 0.68 mm2 and that using the large-capacity forceps was 1.98 mm2 (P < 0.0001). Significant differences between the standard forceps and large-capacity forceps were observed in sensitivity (43 % vs. 70 %), adequacy of the specimens, and submucosal tissue sampling rate.

Conclusions: Large-capacity forceps performed better than standard forceps in terms of size, adequacy of the sample, submucosal sampling rate, and detection of neoplasia.

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M. IkedaMD 

Division of Gastroenterology
Department of Internal Medicine
Toho University Ohashi Medical Center

2-17-6 Ohashi Meguro-ku
Tokyo 153-8515
Japan

Fax: +81-3-34681269

Email: masaki@seirei-numazu.com

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