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Z Gastroenterol ; 57(2): 133-138, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30754057

RESUMO

PURPOSE: The goal of this study was to evaluate the experience of 11 years of wire-guided forceps biopsy via PTCD in patients with obstructive jaundice. MATERIALS AND METHODS: In a retrospective approach, 56 biopsies in 51 patients were analyzed (22 female, 29 male). Data was collected from 2006 to 2016. Mean age was 71 years (range: 34 - 86 years). Data was extracted from dig. Patients' records (KIS, PACS, RIS) to be analyzed in Microsoft Excel. RESULTS: All 56 procedures were technically successful. Stenosis in anastomoses were benign due to scarring in 7 patients and in 9 due to papillitis or others. In 4 patients, results in anastomosis were malignant. In 19 patients without anastomosis, CCC was the diagnosis, thereof 10 klatskin, 9 stenosis in other locations, followed by gastric, pancreatic, and colon carcinoma in 5, 3, and 2 patients. Three patients had a CUP (multimetering in case of more than 1 related category). Overall results were 35 mal. and 16 benign, 76.8 % of all proc. had a correct histopathologic result, and 23.2 % were false negative. Sensitivity was 65.8 %, which results in negative predictive value of 58.1 %. There was no false positive and so specificity was 100 %, as was the positive predictive value. False negative results (no malignancy but clinically and imaging suspect) were corrected by rerunning the procedure, by CT-guided biopsy or by 1 PET-CT. In 1 case the surg. sample brought the result. Minor complications occurred in 8 patients: shivering in 1 case, distinct but hemodynamically not relevant hemobilia in 5 cases, 2 portovenal bleedings. All bleedings were short-term and self-limiting. CONCLUSION: Despite good feasibility, low peri- and post-interv. risk and high validity the forceps biopsy via PTCD is not widely used. For experienced interventionalists, it is an effective method for obtaining histology.


Assuntos
Ductos Biliares , Neoplasias do Sistema Biliar , Biópsia , Colestase , Cicatriz , Adulto , Idoso , Idoso de 80 Anos ou mais , Ductos Biliares/cirurgia , Neoplasias do Sistema Biliar/complicações , Neoplasias do Sistema Biliar/diagnóstico , Biópsia/métodos , Biópsia/estatística & dados numéricos , Colestase/etiologia , Colestase/cirurgia , Cicatriz/complicações , Cicatriz/diagnóstico , Constrição Patológica/complicações , Constrição Patológica/etiologia , Feminino , Humanos , Icterícia Obstrutiva/etiologia , Masculino , Pessoa de Meia-Idade , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Estudos Retrospectivos , Sensibilidade e Especificidade , Instrumentos Cirúrgicos
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