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학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
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연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
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Traditionally, biliary lesions have been considered to be indeterminate when a diagnosis cannot be made after basic laboratory work-up, abdominal imaging and endoscopic retrograde cholangiopancreatography (ERCP) with biliary sampling. Although ERCP is a first-line diagnostic modality for indeterminate biliary lesions, the diagnostic yield of ERCP-based tissue sampling is insufficient. In a recent, peroral cholangioscopy (POC)- guided forceps biopsy and endoscopic ultrasound-guided fine-needle aspiration (EUSFNA) are evolving as reliable diagnostic procedures for indeterminate biliary lesions. In previous studies, EUS-FNA was sensitive and highly specific for diagnosing malignancy in biliary strictures. However, EUS-FNA has several limitations as a routine clinical procedure for all biliary strictures. Newly developed POC systems, such as the SpyGlass direct visualization system and direct POC using an ultra-slim endoscope, have led to excessive improvements in technical performance and diagnostic yields for biliary strictures. However, the performance of POC-guided target biopsy for distal bile duct strictures is technically difficult, and this approach has a limited ability to diagnose biliary strictures caused by non-intraductal, extrinsic compressed malignancies, such as a pancreatic cancer. Therefore, a tailored approach using optimized endoscopic modalities that are specific to the characteristics of a given biliary stricture is needed to achieve a high diagnostic yield for indeterminate biliary lesions.
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참고문헌 (32)
참고문헌 신청
Ramchandani M / 2011 / Role of single-operator peroral cholangioscopy in the diagnosis of indeterminate biliary lesions: a single-center, prospective study / Gastrointest Endosc 74:511~519
Draganov PV / 2012 / Diagnostic accuracy of conventional and cholangioscopy-guided sampling of indeterminate biliary lesions at the time of ERCP: a prospective, long-term follow-up study / Gastrointest Endosc 75:347~353
Sun X / 2015 / Is single-operator peroral cholangioscopy a useful tool for the diagnosis of indeterminate biliary lesion? A systematic review and meta-analysis / Gastrointest Endosc 82:79~87
Korc P / 2016 / ERCP tissue sampling / Gastrointest Endosc 84:557~571
Gabbert C / 2013 / Advanced techniques for endoscopic biliary imaging: cholangioscopy, endoscopic ultrasonography, confocal, and beyond / Gastrointest Endosc Clin N Am 23:625~646
Draganov PV / 2012 / Diagnostic accuracy of conventional and cholangioscopy-guided sampling of indeterminate biliary lesions at the time of ERCP: a prospective, long-term follow-up study / Gastrointest Endosc 75:347~353
Sun X / 2015 / Is single-operator peroral cholangioscopy a useful tool for the diagnosis of indeterminate biliary lesion? A systematic review and meta-analysis / Gastrointest Endosc 82:79~87
Korc P / 2016 / ERCP tissue sampling / Gastrointest Endosc 84:557~571
Gabbert C / 2013 / Advanced techniques for endoscopic biliary imaging: cholangioscopy, endoscopic ultrasonography, confocal, and beyond / Gastrointest Endosc Clin N Am 23:625~646
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