Percutaneous transluminal forceps biopsy of obstructive CBD lesion via transcholecystic approach

To evaluate the effectiveness of transcholecystic percutaneous transluminal forceps biopsy in patent with obstructive CBD lesion.

Materials and Methods: The retrospective analysis was conducted in this single center study of 28 patients (15 males, 13 females; mean age, 72.5 years; range, 47-85) with obstructive jaundice between December 2008 and March 2024. In each patient, three to six specimens (mean, 4.7) were obtained from the lesion with biopsy forceps. The final diagnosis was confirmed with histopathologic date, or clinical and radiologic follow-up. Technical success, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), accuracy and complications were evaluated. The technical success rate between two radiologists was compared using Pearson's Chi-square test.

Results:

The technical success rate of transcholecystic percutaneous transluminal forceps biopsy was achieved at 92.9% (26/28). The technical success rate did not show statistically significant differences between the two radiologists (p=0.336). The diagnostic performance of biopsy in biliary obstructions was as follows: sensitivity, 86.7%; specificity, 100%; PPV, 100%;. NPV, 84.6%; and accuracy, 92.3%. Three patient (3/26, 11.5%) developed procedure related complication including cystic duct stricture (1/26, 3.8%) which was managed by catheter stenting and pain (2/26, 7.7%) which was managed conservatively.

Conclusion:

Transcholecystic percutaneous transluminal forceps biopsy seems to be technically feasible and safe procedure. Transcholecystic approach can be used as an alternative route for biliary tract biopsy.