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내시경적 경유두 조직생검의 진단적 의의

Other Titles
 Endoscopic Transpapillary Biopsy for the Diagnosis of Patients with Pancreaticobiliary Ductal Strictures 
 송건훈  ;  박승우  ;  송시영  ;  정재복  ;  문영명  ;  강진경  ;  박인서 
 Korean Journal of Gastrointestinal Endoscopy (대한소화기내시경학회지), Vol.19(3) : 405-413, 1999 
Journal Title
 Korean Journal of Gastrointestinal Endoscopy (대한소화기내시경학회지) 
Issue Date
Endoscopic transpapillary biopsy ; Pancreaticobiliary stricture ; Endoscopic
Background/Aims: Many diseases and conditions are responsible for pancreaticobiliary ductal strictures. In such patients, histologic diagnosis is crucial to determine therapeutic modalities and to predict their outcomes, as well as to avoid unnecessary operations for tissue diagnosis. To evaluate the diagnostic role of endoscopic transpapillary biopsys (ETPB), this technique was performed in patients with pancreaticobiliary ductal strictures suggestive of malignancy. Methods: After visualization of the pancreaticobiliary tree and the lesion by endoscopic retrograde cholangiopancreatography (ERCP), an ETPB of the lesion was conducted with or without an endoscopic sphincterotomy (EST) in sixty-four patients with pancreaticobiliary ductal strictures. The biopsy results were analysed according to the morphology of the lesion, site of the stricture, number of biopsys and whether or not an EST was done. Results: The final diagnoses of the sixty-four patients included forty bile duct cancers (62.5%), nine pancreatic cancers (14.1%), four metastatic cancers (6.3%), and eleven benign ductal strictures (17.2%) such as biliary stones, cholangitis, etc. The sites of the strictures were located in the upper bile duct in thirty-two patients (50.0%), the middle bile duct in twenty-two (34.4%), the lower bile duct in three (4.7%), the pancreatic head in four (6.3%), and the pancreatic body in three (4.7%). Adequate tissue specimens for pathologic examination were obtained in fifty-four cases (84.4%). An ETPB was possible without an EST in nineteen cases (29.7%). The ETPB results revealed sensitivity of 60.4% (32/53), specificity of 100% (6/6), positive predictive value of 100% (32/32), and negative predictive value of 34.4% (11/32). The sensitivity of the ETPB was higher in the EST group than in group without an EST. There was no statistical significance however, according to tumor morphology, site, or number of biopsys. Conclusions: It is recommended that an ETPB, being a safe and effective method, should be performed as a diagnostic procedure during an ERCP for patients with pancreaticobiliary ductal strictures of unknown causes.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Park, Seung Woo(박승우) ORCID logo https://orcid.org/0000-0001-8230-964X
Song, Si Young(송시영) ORCID logo https://orcid.org/0000-0002-1417-4314
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