Utility of bile duct brushings for the early detection of cholangiocarcinoma in patients with primary sclerosing cholangitis

Journal of Clinical Gastroenterology
Stephen L MoffPaul J Thuluvath

Abstract

In patients with primary sclerosing cholangitis, there are no reliable markers or imaging modalities to detect malignant changes or early cholangiocarcinoma when curative interventions may still be possible. Clinical features and outcomes were evaluated for 47 patients who underwent 101 endoscopic retrograde cholangiopancreatography (ERCP) procedures with bile duct brushings and cytopathologic examination for the detection of malignant changes between January 2001 and 2004. Bile duct cytology was characterized as unsatisfactory, benign, atypical, or malignant. Fifteen patients had at least one sample that was abnormal. Patients with abnormal findings were older (P = 0.03); otherwise the groups were similar. Three of six patients with marked atypia have undergone transplantation for these abnormal findings, and of these, two had cholangiocarcinoma and one had no cancer detected in the explant. Of the nine patients with focal atypia, seven are doing well, one underwent transplantation for marked atypia seen on brushings at another hospital, and the other underwent transplantation for decompensated cirrhosis. Two patients with benign findings developed cholangiocarcinoma, whereas 29 others have not. Cytopathologic examination of b...Continue Reading

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Citations

Apr 28, 2009·Cardiovascular and Interventional Radiology·Benjamin WiesingerJakub Wiskirchen
Nov 14, 2007·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Richard D Schulick
Apr 25, 2006·Journal of Clinical Gastroenterology·Priya Jamidar
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Nov 6, 2015·Journal of Gastrointestinal Cancer·Ufuk Barış KuzuErtuğrul Kayaçetin
Dec 7, 2007·Gastrointestinal Endoscopy·Jason P EtzelKris V Kowdley
Oct 30, 2016·Gastrointestinal Endoscopy·Basile NjeiUdayakumar Navaneethan
Apr 22, 2017·Journal of Hepatology·UNKNOWN European Society of Gastrointestinal EndoscopyUNKNOWN European Association for the Study of the Liver
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