PMID- 36118635 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20220920 IS - 2364-3722 (Print) IS - 2196-9736 (Electronic) IS - 2196-9736 (Linking) VI - 10 IP - 9 DP - 2022 Sep TI - Histological assessment of new cholangioscopy-guided forceps in ERCP biliary stricture sampling: a blinded comparative study. PG - E1233-E1237 LID - 10.1055/a-1897-4686 [doi] AB - Background and study aims Obtaining quality tissue during ERCP biliary stricture sampling is of paramount importance for a timely diagnosis. While single-operator cholangioscopy (SOC)-guided biopsies have been suggested to be the superior biliary tissue acquisition modality given direct tissue visualization, less is known about the specimen histological quality. We aimed to analyze the specimen quality of SOC biopsies and compare the new generation forceps with prior "legacy" forceps. Patients and methods Patients who underwent SOC from January 2017-August 2021 for biliary sampling were reviewed. In February 2020, the SOC-guided biopsy forceps were changed from legacy SpyBite to the SpyBite Max forceps (max). Specimens were assessed by blinded pathologists for crush artifact (none, mild, or severe) and gross size (greatest dimension in mm). Crush artifact and gross size were compared between the two groups. The diagnostic performance characteristics for cholangiocarcinoma (CCA), were assessed in an exploratory fashion. Results Eighty-one patients (max = 27, legacy = 54) with similar baseline characteristics were included in this study. On blinded pathological assessment, 58 % had crush artifact, without significant differences between the two groups (Max 63 % vs. Legacy 56 %; P = 0.64). A similar mean specimen size was found (max 3 mm vs. legacy 3.2 mm; P = 0.24). The overall prevalence of CCA was 40 %. The sensitivity, specificity, positive predictive value, and negative predictive value of the entire cohort using a combination of cytology, fluorescence in situ hybridization, and SOC-guided biopsies were 78.1 %, 91.8 %, 86.2 %, and 86.5 %, respectively. No difference between legacy or max groups was found. Conclusions A high rate of crush artifact was found in SOC-guided biopsy specimens. Further investigation regarding proper biopsy technique and handling is necessary to increase the diagnostic yield with SOC-guided biopsies. CI - The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/). FAU - Vargas, Eric J AU - Vargas EJ AD - Department of Gastroenterology and Hepatology, Mayo Clinic Rochester, Rochester, Minnesota, United States. FAU - Wang, Yaohong AU - Wang Y AD - Vanderbilt University School of Medicine, Pathology, Microbiology and Immunology, Nashville, Tennessee, United States. FAU - Chen, Zongming Eric AU - Chen ZE AD - Department of Pathology, Mayo Clinic Rochester, Rochester, Minnesota, United States. FAU - Abusaleh, Rami AU - Abusaleh R AD - Department of Gastroenterology and Hepatology, Mayo Clinic Rochester, Rochester, Minnesota, United States. FAU - Storm, Andrew C AU - Storm AC AD - Department of Gastroenterology and Hepatology, Mayo Clinic Rochester, Rochester, Minnesota, United States. FAU - Martin, John A AU - Martin JA AD - Department of Gastroenterology and Hepatology, Mayo Clinic Rochester, Rochester, Minnesota, United States. FAU - Law, Ryan J AU - Law RJ AD - Department of Gastroenterology and Hepatology, Mayo Clinic Rochester, Rochester, Minnesota, United States. FAU - Dayyeh, Barham K Abu AU - Dayyeh BKA AD - Department of Gastroenterology and Hepatology, Mayo Clinic Rochester, Rochester, Minnesota, United States. FAU - Levy, Michael J AU - Levy MJ AD - Department of Gastroenterology and Hepatology, Mayo Clinic Rochester, Rochester, Minnesota, United States. FAU - Petersen, Bret AU - Petersen B AD - Department of Gastroenterology and Hepatology, Mayo Clinic Rochester, Rochester, Minnesota, United States. FAU - Chandrasekhara, Vinay AU - Chandrasekhara V AD - Department of Gastroenterology and Hepatology, Mayo Clinic Rochester, Rochester, Minnesota, United States. LA - eng PT - Journal Article DEP - 20220914 PL - Germany TA - Endosc Int Open JT - Endoscopy international open JID - 101639919 PMC - PMC9473850 COIS- Competing interests Dr. Storm is a consultant for Apollo Endosurgery and received research support from Apollo Endosurgery and Boston Scientific. Dr. Law is a consultant for ConMed and Medtronic and receives royalties from UpToDate. Dr. Abu Dayyeh reports consultant roles with Endogenex, Endo-TAGSS, Metamodix, and BFKW; consultant and grant or research support from USGI, Cairn Diagnostics, Aspire Bariatrics, Boston Scientific; speaker roles with Olympus, Johnson and Johnson; speaker and grant or research support from Medtronic, Endogastric solutions; and research support from Apollo Endosurgery and Spatz Medical. Dr. Petersen is a consultant for Olympus America and investigator for Boston Scientific and Ambu. Dr. Chandrasekhara is a consultant for Covidien LP and Boston Scientific and is a shareholder in Nevakar Corp. The remaining authors have no conflicts or funding to disclose. EDAT- 2022/09/20 06:00 MHDA- 2022/09/20 06:01 PMCR- 2022/09/01 CRDT- 2022/09/19 04:14 PHST- 2021/12/03 00:00 [received] PHST- 2022/06/24 00:00 [accepted] PHST- 2022/09/19 04:14 [entrez] PHST- 2022/09/20 06:00 [pubmed] PHST- 2022/09/20 06:01 [medline] PHST- 2022/09/01 00:00 [pmc-release] AID - 10.1055/a-1897-4686 [doi] PST - epublish SO - Endosc Int Open. 2022 Sep 14;10(9):E1233-E1237. doi: 10.1055/a-1897-4686. eCollection 2022 Sep.