{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T07:40:11Z","timestamp":1760082011728,"version":"build-2065373602"},"reference-count":21,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2025,7,18]],"date-time":"2025-07-18T00:00:00Z","timestamp":1752796800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Gastro and Hepatol"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background and Aim<\/jats:title><jats:p>Malignant biliary obstruction (MBO) typically results from cancers like pancreatic adenocarcinoma, cholangiocarcinoma, and gallbladder carcinoma, and it often presents at an advanced stage. Diagnostic tools such as ERCP and EUS\u2010FNA are commonly used for tissue sampling, but each has limitations regarding accuracy and cost. This study aimed to compare the diagnostic accuracy and cost\u2010effectiveness of cell block (CB) cytology collected during ERCP\u2010guided stenting with the traditional EUS\u2010FNA plus ERCP\u2010guided stenting approach in patients with unresectable MBO.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This prospective observational study included 102 patients with advanced unresectable MBO who underwent both EUS\u2010FNA and ERCP\u2010guided stenting with CB sampling. The study evaluated the diagnostic yield of three strategies: CB alone, EUS\u2010FNA alone, and a combination of both methods. A cost\u2010effectiveness analysis was conducted using publicly available reimbursement rates from the public healthcare system to assess potential procedural cost savings.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The diagnostic yield for EUS\u2010FNA (82.35%) was higher than for CB (72.54%), though the difference was not statistically significant (<jats:italic>p<\/jats:italic>\u2009=\u20090.23). Combining both methods increased the diagnostic yield to 93.13% (<jats:italic>p<\/jats:italic>\u2009=\u20090.04). CB performed better in cases with direct biliary invasion (88.23% vs. 79.41% for EUS\u2010FNA, <jats:italic>p<\/jats:italic>\u2009=\u20090.01). A cost reduction of 319.17 \u20ac per case was achieved using a CB\u2010only strategy in appropriate cases.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>EUS\u2010FNA remains superior for diagnosing extrinsic MBO, but ERCP\u2010based CB offers a cost\u2010effective and reliable diagnostic option, particularly for biliary tract cancers. The combination of both approaches enhances diagnostic accuracy, supporting their concurrent use in specific clinical scenarios, while optimizing costs.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jgh.70014","type":"journal-article","created":{"date-parts":[[2025,7,18]],"date-time":"2025-07-18T11:04:42Z","timestamp":1752836682000},"page":"2533-2539","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["ERCP\u2010Based Cell Block: A Potential One\u2010Stop Shop in the Management of Malignant Biliary Obstruction"],"prefix":"10.1111","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5872-8630","authenticated-orcid":false,"given":"Rare\u0219","family":"Cr\u0103ciun","sequence":"first","affiliation":[{"name":"Department of Internal Medicine \u201cIuliu Ha\u021bieganu\u201d University of Medicine and Pharmacy  Cluj\u2010Napoca Romania"},{"name":"Department of Gastroenterology \u201cProf. Dr. Octavian Fodor\u201d Institute of Gastroenterology and Hepatology  Cluj\u2010Napoca Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrada","family":"Seicean","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine \u201cIuliu Ha\u021bieganu\u201d University of Medicine and Pharmacy  Cluj\u2010Napoca Romania"},{"name":"Department of Gastroenterology \u201cProf. Dr. Octavian Fodor\u201d Institute of Gastroenterology and Hepatology  Cluj\u2010Napoca Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cristina","family":"Pojoga","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology \u201cProf. Dr. Octavian Fodor\u201d Institute of Gastroenterology and Hepatology  Cluj\u2010Napoca Romania"},{"name":"UBB Med, Department of Clinical Psychology and Psychotherapy International Institute for Advanced Study of Psychotherapy and Applied Mental Health, Babe\u0219\u2010Bolyai University  Cluj\u2010Napoca 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