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Master Thesis

Évaluation prospective de la performance de l’aspiration de bile associée au brossage biliaire par CPRE dans le diagnostic des sténoses biliaires malignes

Abstract : Background and Aim: Endobiliary brushing during endoscopic retrograde cholangiopancreatography (ERCP) is the main technique used to diagnose a malignant stricture, but has poor sensitivity. This study evaluated the diagnostic performance of bile aspiration associated with biliary brushing during ERCP to diagnose a malignant stricture, compared to brushing alone. Patients and Methods: Between January 2007 and December 2012, all consecutive patients undergoing ERCP to treat a biliary stricture were included. After a biliary sphincterotomy, 3–10 mL of bile was aspirated into the brush catheter and collected in a dry sterile tube before and after brushing (to yield three samples). Brushing was performed as commonly recommended. Results: 111 patients (68 males, 43 females) were included; mean age 67±15.4 years. A final diagnosis of a malignant stricture was established in 51 patients, including 43 cholangiocarcinomas; 60 patients had benign strictures. Specificity and positive predictive values were 100% for all samples. The diagnostic performance of the three-sample combination of bile aspiration + brushing + bile aspiration was significantly greater than brushing alone (p=0.004): sensitivity (Se)=84.3% vs. Se=66.7%. The three combined samples gave a negative predictive value of 88.2%, and a diagnostic accuracy of 92.8%. When the cytology in the three combined samples was considered normal, the negative predictive value was 94.7%. Conclusion: In cases of biliary stricture, conducting bile aspiration before and after brushing significantly increased the ability to diagnose a malignant stricture with a sensitivity of 84.3% (p=0.004).
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-01213969
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Submitted on : Friday, October 9, 2015 - 3:11:59 PM
Last modification on : Tuesday, May 11, 2021 - 11:36:18 AM
Long-term archiving on: : Sunday, January 10, 2016 - 10:32:22 AM

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  • HAL Id : dumas-01213969, version 1

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Gaël Stéphane Wenceslas Roth. Évaluation prospective de la performance de l’aspiration de bile associée au brossage biliaire par CPRE dans le diagnostic des sténoses biliaires malignes. Médecine humaine et pathologie. 2015. ⟨dumas-01213969⟩

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