Transpapillary biopsy in gallbladder disease

Background: Endoscopic biopsy is routine in gastrointestinal disease; simil arly, histopathologic diagnosis is desirable in gallbladder disease. In thi s study we examined the clinical usefulness and the problems associated wit h transpapillary gallbladder biopsy. Methods: Transpapillary gallbladder biopsy was attempted in 9 patients with gallbladder disease. After inserting a catheter sheath into the gallbladde r using a guidewire via the transpapillary route without sphincterotomy, we inserted a biopsy forceps into the lumen of the sheath up to the gallbladd er lumen and obtained specimens. Results: We could obtain sufficient specimens for histopathologic diagnosis in 8 of 9 cases (88.9%). Of the 8 successful cases, targeted specimens wer e obtained in 7 (87.5%). Diagnostic accuracy with respect to malignant vers us benign disease was 100% (2 of 2) and 83.3% (5 of 6), respectively. There were no complications. Conclusion: Transpapillary gallbladder biopsy is a clinically useful techni que because it facilitates histopathologic diagnosis and therefore guides t he choice of therapy.