Aim: This study investigated the diagnostic performance and safety of percutaneous transhepatic forceps biopsy (PTFB) and percutaneous transhepatic endobiliary brushing (PTEB) in patients with suspected malignant biliary stricture.Materials and Methods: A total of 46 patients (19 females, 27 males; mean age, 69.1 ± 10.7 years) with suspected malignant biliary strictures who underwent percutaneous transhepatic biliary drainage (PTBD) followed by either PTFB or PTEB were retrospectively included in this study. The variables recorded and analysed comprised demographic features, tumour type and localization, histopathological findings, and complication rates. Cytological and histopathological results were compared with a final diagnosis, which included radiological, pathological, and clinical data. The diagnostic performance of each method was subsequently evaluated in terms of sensitivity, specificity, accuracy and predictive value.Results: Among the patients, 24 underwent PTFB and 22 underwent PTEB, with a technical success rate of 100%. The final diagnosis of malignancy was confirmed in 43 of the 46 patients, while 3 patients were diagnosed with benign disease. The biopsy was performed via a right-sided approach in 43 patients and a left-sided approach in 3 patients. The sensitivity and accuracy were 63.6% and 66.7% for PTFB, and 38.1% and 40.9% for PTEB, respectively. Our study cohort exhibited an overall complication rate of 8.7%, comprising three minor (6.5%) and one major (2.2%) complication.Conclusions: For patients indicated for PTBD, PTFB provided higher diagnostic performance than PTEB and represented a safe, feasible diagnostic method.
Asfuroğlu et al. (Fri,) studied this question.