THE VALUE OF HISTOLOGICAL ANALYSIS OF OCCLUDED BILIARY ENDOPROSTHESES

Background and Study Aims: Histological diagnosis of biliary stricture s remains unsatisfactory, despite the availability of various endoscop ic sampling procedures. The aim of our study was to assess the potenti al diagnostic yield of histological processing of occluded biliary end oprostheses inserted for palliation of malignant biliary stenoses. Pat ients and Methods: Over a period of one year, we prospectively collect ed biliary endoprostheses at the time of stent removal due to stent ob struction. Thirty-nine stents, inserted a mean of 94 days earlier for presumed malignant biliary strictures, were recovered. Their contents were examined histologically by two independent pathologists. Results: Malignancy was found in 14 of 36 patients (39%), The sensitivity was highest in gallbladder carcinoma (66 %), followed by choledochal and a mpullary carcinoma (50 %), metastatic carcinoma (33 %), and pancreatic carcinoma (25 %), The specificity of the method was 100 %. Conclusion s: We advocate systematic histological or cytological examination, or both, of occluded biliary endoprostheses, since the technique is of lo w invasiveness, has low costs, and is easy to perform, especially if o ther methods of tissue diagnosis have failed.