{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T11:35:45Z","timestamp":1790249745845,"version":"4.1.0"},"reference-count":0,"publisher":"Georg Thieme Verlag KG","issue":"01","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Endoscopy"],"published-print":{"date-parts":[[2019,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Background\u2002Although endoscopic retrograde cholangiopancreatography (ERCP) is a first-line diagnostic modality for suspected malignant biliary stricture (MBS), the diagnostic yield of ERCP-based tissue sampling is insufficient. Peroral cholangioscopy-guided forceps biopsy (POC-FB) and endoscopic ultrasound-guided fine-needle aspiration biopsy (EUS-FNAB) are evolving as reliable diagnostic procedures for inconclusive MBS.\u200aThis study aimed to evaluate the usefulness of a diagnostic approach using POC-FB or EUS-FNAB according to the stricture location in patients with suspected MBS.<\/jats:p><jats:p>\n          Methods\u2002Consecutive patients diagnosed with suspected MBS with obstructive jaundice and\/or cholangitis were enrolled prospectively. ERCP with transpapillary forceps biopsy (TPB) was performed initially. When malignancy was not confirmed by TPB, POC-FB using a SpyGlass direct visualization system or direct POC using an ultraslim endoscope was performed for proximal strictures, and EUS-FNAB was performed for distal strictures as a follow-up biopsy. <\/jats:p><jats:p>\n          Results\u2002Among a total of 181 patients, initial TPB showed malignancy in 122 patients, and the diagnostic accuracy of initial TPB was 71.8\u200a% (95\u200a% confidence interval [CI] 65.3\u200a%\u200a\u2013\u200a78.4\u00a0%]. Of the 59 patients in whom TPB was negative for malignancy, 32 had proximal biliary strictures and underwent successful POC. The remaining 27 patients had distal strictures and underwent successful EUS-FNAB. The accuracy of malignancy detection using POC-FB for proximal biliary strictures and EUS-FNAB for distal biliary strictures was 93.6\u200a% (95\u200a%CI 84.9\u200a%\u2212100\u200a%) and 96.3\u200a% (95\u200a%CI 89.2\u200a%\u2212100\u00a0%), respectively. The overall diagnostic accuracy for the combination of TPB with either POC-FB for proximal strictures and EUS-FNAB for distal strictures was 98.3\u200a% (95\u00a0%CI 95.9\u200a%\u2212100\u200a%) and 98.4\u200a% (95\u200a%CI 95.3\u200a%\u2212100\u200a%), respectively. <\/jats:p><jats:p>\n          Conclusions\u2002An approach using POC-FB or EUS-FNAB according to the stricture location may be useful in the diagnosis of suspected MBS.<\/jats:p>","DOI":"10.1055\/a-0645-1395","type":"journal-article","created":{"date-parts":[[2019,1,2]],"date-time":"2019-01-02T14:24:39Z","timestamp":1546439079000},"page":"50-59","source":"Crossref","is-referenced-by-count":36,"title":["Tissue acquisition for diagnosis of biliary strictures using peroral cholangioscopy or endoscopic ultrasound-guided fine-needle aspiration"],"prefix":"10.1055","volume":"51","clinical-trial-number":[{"clinical-trial-number":"umin000020193","registry":"10.18810\/umin-japan"}],"author":[{"given":"Yun","family":"Lee","sequence":"additional","affiliation":[{"name":"Digestive Disease Center and Research Institute, Department of Internal Medicine, SoonChunHyang University School of Medicine, Bucheon and Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jong","family":"Moon","sequence":"additional","affiliation":[{"name":"Digestive Disease Center and Research Institute, Department of Internal Medicine, SoonChunHyang University School of Medicine, Bucheon and Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyun","family":"Choi","sequence":"additional","affiliation":[{"name":"Digestive Disease Center and Research Institute, Department of Internal Medicine, SoonChunHyang University School of Medicine, Bucheon and Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hee","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Pathology, SoonChunHyang University School of Medicine, Bucheon, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyun","family":"Lee","sequence":"additional","affiliation":[{"name":"Digestive Disease Center and Research Institute, Department of Internal Medicine, SoonChunHyang University School of Medicine, Bucheon and Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tae","family":"Lee","sequence":"additional","affiliation":[{"name":"Digestive Disease Center and Research Institute, Department of Internal Medicine, SoonChunHyang University School of Medicine, Bucheon and Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moon","family":"Choi","sequence":"additional","affiliation":[{"name":"Digestive Disease Center and Research Institute, Department of Internal Medicine, SoonChunHyang University School of Medicine, Bucheon and Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sang-Woo","family":"Cha","sequence":"additional","affiliation":[{"name":"Digestive Disease Center and Research Institute, Department of Internal Medicine, SoonChunHyang University School of Medicine, Bucheon and Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Young","family":"Cho","sequence":"additional","affiliation":[{"name":"Digestive Disease Center and Research Institute, Department of Internal Medicine, SoonChunHyang University School of Medicine, Bucheon and Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sang-Heum","family":"Park","sequence":"additional","affiliation":[{"name":"Digestive Disease Center and Research Institute, Department of Internal Medicine, SoonChunHyang University School of Medicine, Bucheon and Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2018,9,5]]},"container-title":["Endoscopy"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-0645-1395.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,1,17]],"date-time":"2019-01-17T21:23:50Z","timestamp":1547760230000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-0645-1395"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,9,5]]},"references-count":0,"journal-issue":{"issue":"01","published-online":{"date-parts":[[2018,12,20]]},"published-print":{"date-parts":[[2019,1]]}},"URL":"https:\/\/doi.org\/10.1055\/a-0645-1395","relation":{},"ISSN":["0013-726X","1438-8812"],"issn-type":[{"value":"0013-726X","type":"print"},{"value":"1438-8812","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,9,5]]}}}