모호한 담관병변의 진단: 경구 담도 내시경 및 초음파 내시경Advances of Peroral Cholangioscopy and EUS for Indeterminate Biliary Lesions
- Other Titles
- Advances of Peroral Cholangioscopy and EUS for Indeterminate Biliary Lesions
- Authors
- 이윤나
- Issue Date
- 2020
- Publisher
- 대한췌담도학회
- Keywords
- Biliary tract diseases; Endoscopic ultrasound-guided fine needle aspiration; Peroral cholangioscopy
- Citation
- 대한췌담도학회지, v.25, no.1, pp 29 - 33
- Pages
- 5
- Journal Title
- 대한췌담도학회지
- Volume
- 25
- Number
- 1
- Start Page
- 29
- End Page
- 33
- URI
- https://scholarworks.bwise.kr/sch/handle/2021.sw.sch/19628
- ISSN
- 1976-3573
2288-0941
- Abstract
- Traditionally, biliary lesions have been considered to be indeterminate when a diagnosis cannot be made after basic laboratory work-up, abdominal imaging and endoscopic retrograde cholangiopancreatography (ERCP) with biliary sampling. Although ERCP is a first-line diagnostic modality for indeterminate biliary lesions, the diagnostic yield of ERCP-based tissue sampling is insufficient. In a recent, peroral cholangioscopy (POC)- guided forceps biopsy and endoscopic ultrasound-guided fine-needle aspiration (EUSFNA) are evolving as reliable diagnostic procedures for indeterminate biliary lesions. In previous studies, EUS-FNA was sensitive and highly specific for diagnosing malignancy in biliary strictures. However, EUS-FNA has several limitations as a routine clinical procedure for all biliary strictures. Newly developed POC systems, such as the SpyGlass direct visualization system and direct POC using an ultra-slim endoscope, have led to excessive improvements in technical performance and diagnostic yields for biliary strictures.
However, the performance of POC-guided target biopsy for distal bile duct strictures is technically difficult, and this approach has a limited ability to diagnose biliary strictures caused by non-intraductal, extrinsic compressed malignancies, such as a pancreatic cancer. Therefore, a tailored approach using optimized endoscopic modalities that are specific to the characteristics of a given biliary stricture is needed to achieve a high diagnostic yield for indeterminate biliary lesions.
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Collections - College of Medicine > Department of Internal Medicine > 1. Journal Articles
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