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©2014 Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Endosc. Jul 16, 2014; 6(7): 312-317
Published online Jul 16, 2014. doi: 10.4253/wjge.v6.i7.312
Published online Jul 16, 2014. doi: 10.4253/wjge.v6.i7.312
Improved endoscopic retrograde cholangiopancreatography brush increases diagnostic yield of malignant biliary strictures
Frederick K Shieh, Harshit S Khara, Matthew J Shellenberger, Amitpal S Johal, David L Diehl, Department of Gastroenterology and Nutrition, Geisinger Medical Center, Danville, PA 17822, United States
Adelina Luong-Player, Haiyan Liu, Fan Lin, Department of Pathology and Laboratory Medicine, Geisinger Medical Center, Danville, PA 17822, United States
Author contributions: All authors contributed equally to this work; Shieh FK, Khara HS, Shellenberger MJ, Johal AS and Diehl DL were involved in the clinical management, procedural performance and tissue acquisition of the cases; Luong-Player A, Liu H and Lin F were involved in the cytopathological analysis and diagnostic assessment of the cases.
Correspondence to: David L Diehl, MD, FACP, FASGE, Director of Interventional Endoscopy, Department of Gastroenterology and Nutrition, Geisinger Medical Center, 100 N. Academy Avenue, 21-11, Danville, PA 17822, United States. dldiehl@geisinger.edu
Telephone: +1-570-2716856 Fax: +1-570-2716852
Received: March 17, 2014
Revised: April 30, 2014
Accepted: June 10, 2014
Published online: July 16, 2014
Revised: April 30, 2014
Accepted: June 10, 2014
Published online: July 16, 2014
Core Tip
Core tip: The sensitivity of brush cytology for biliary strictures has historically been low (around 30%-60%). Many studies have described efforts to improve cellular yield and diagnostic accuracy with varying success. We describe the development of an improved biliary brush cytology protocol with the use of a new biliary brush design which more than doubled the diagnostic yield of our brush cytology as compared to the historical cases. Cytopathological analysis also showed increased cellular yield, and thus better diagnostic accuracy, with the improved protocol implementation.