Abstract Background Diagnosing biliary strictures (BSs) presents significant challenges. Brush cytology (BC), a common clinical method, has a suboptimal diagnostic yield. Transpapillary forceps biopsy (TPB) can improve diagnostic accuracy but is technically demanding and has a relatively low success rate, partly due to a lack of effective biopsy forceps. To address this, we have developed a novel type of guidewire-introduced bile duct biopsy forceps. This study retrospectively evaluates the clinical value of this new forceps combined with bile duct brush cytology (BC) compared with BC alone. Methods During the endoscopic retrograde cholangiopancreatography (ERCP), bile duct biopsy was attempted first using the new forceps under fluoroscopic guidance. If feasible, BC was performed afterward. The obtained samples were sent for pathological and cytological examination. If biopsy was unsuccessful, only BC was performed. Results A total of 262 patients were enrolled. The sensitivity of bile duct biopsy was 60.8%, slightly lower than that of BC (66.1%). However, combining TPB with BC significantly increased the diagnostic sensitivity for malignant biliary stricture to 77.7%. Conclusion The newly developed guidewire-introduced bile duct biopsy forceps effectively reduce the procedural difficulty and enhance the success rate of bile duct biopsy. It is a safe and effective tool for diagnosing biliary stricture. Furthermore, combining bile duct biopsy with BC significantly increases the diagnostic accuracy of malignant biliary stricture.
Wei et al. (Tue,) studied this question.