CC BY-NC-ND 4.0 · Endosc Int Open 2018; 06(08): E984-E988
DOI: 10.1055/a-0591-2740
Original article
Owner and Copyright © Georg Thieme Verlag KG 2018

Novel triple lumen catheter for ERCP tissue diagnosis

Martin Goetz
Innere Medizin I, Universitätsklinikum Tübingen, Tübingen, Germany
,
Nisar P. Malek
Innere Medizin I, Universitätsklinikum Tübingen, Tübingen, Germany
› Author Affiliations
Further Information

Publication History

submitted 19 September 2017

accepted after revision 19 January 2018

Publication Date:
03 August 2018 (online)

Abstract

Introduction The ideal endoscopic retrograde cholangiopancreatography (ERCP) tissue sampling technique should be simple, inexpensive, and yield sufficient tissue for histology while permitting contrast-guided targeting under fluorescence and multiple passes into the bile duct. Current techniques do not fulfill these requirements comprehensively. We designed a catheter for optimized targeting of large intrabiliary biopsies.

Methods A 3.5-mm sterile, single-use prototype catheter was developed, with three independent lumina extending continuously to the distal tip for three distinct functions to be available simultaneously: passage of large volume biopsy forceps (1.8 mm), wire guidance (0.035″), and contrast injection.

Results First clinical use in five patients (four transpapillary, one percutaneous access) allowed good intrabiliary manipulation in 4/5 patients. Contrast-guided sampling provided adequate specimens. No adverse events were noted.

Discussion Technical aspects and preliminary clinical data for the novel triple lumen biopsy catheter are encouraging. The catheter allowed wire guidance and contrast application to guide sampling of larger pieces of tissue. In perspective, the working channel could host any accessory for targeted intrabiliary diagnosis and therapy, and catheter use is not limited to bile ducts.

 
  • References

  • 1 Korc P, Sherman S. ERCP tissue sampling. Gastrointest Endosc 2016; 84: 557-571
  • 2 Ponchon T, Gagnon P, Berger F. et al. Value of endobiliary brush cytology and biopsies for the diagnosis of malignant bile duct stenosis: results of a prospective study. Gastrointest Endosc 1995; 42: 565-572
  • 3 Schoefl R, Haefner M, Wrba F. et al. Forceps biopsy and brush cytology during endoscopic retrograde cholangiopancreatography for the diagnosis of biliary stenoses. Scand J Gastroenterol 1997; 32: 363-368
  • 4 Pugliese V, Conio M, Nicolo G. et al. Endoscopic retrograde forceps biopsy and brush cytology of biliary strictures: a prospective study. Gastrointest Endosc 1995; 42: 520-526
  • 5 Nishikawa T, Tsuyuguchi T, Sakai Y. et al. Comparison of the diagnostic accuracy of peroral video-cholangioscopic visual findings and cholangioscopy-guided forceps biopsy findings for indeterminate biliary lesions: a prospective study. Gastrointest Endosc 2013; 77: 219-226
  • 6 Ogura T, Imanishi M, Kurisu Y. et al. Prospective evaluation of digital single-operator cholangioscope for diagnostic and therapeutic procedures (with videos). Dig Endosc 2017; 29: 782-789
  • 7 Rey JW, Hansen T, Dumcke S. et al. Efficacy of SpyGlass(TM)-directed biopsy compared to brush cytology in obtaining adequate tissue for diagnosis in patients with biliary strictures. World J Gastrointest Endosc 2014; 6: 137-143
  • 8 Morita S, Kanefuji T, Hoshi T. et al. A novel technique for biliary biopsy using the sheath of a plastic stent and a non-return valve. Endoscopy 2017; 49: E9-E10