Comparison of Biliary Forceps Biopsy and Brush Cytology

This study has been completed.
Sponsor:
Collaborator:
Heidelberg University
Information provided by:
University of Ulm
ClinicalTrials.gov Identifier:
NCT01145248
First received: June 14, 2010
Last updated: June 15, 2010
Last verified: May 2010
  Purpose

Cholangiocarcinomas (CCCs) are malignant tumors arising from the biliary epithelium. CCCs are characterised by a high mortality and the only curable therapy is complete tumor resection, if feasible, or in some cases liver transplantation. Since surgery for CCC is a procedure associated with a high mortality itself it needs to be ascertained that an accurate preoperative diagnosis has been established. However, it often appears to be difficult to get a preoperative pathological diagnosis, since it is difficult to obtain tumor specimens using cytologic brushings, biopsy forceps, bile aspiration or endoscopic ultrasonography guided-fine needle aspiration. This is reflected by a nearly 100% specificity but low sensitivity rates.

The aim of this study is to compare a new method of biliary biopsy using a double-balloon enteroscopy (DBE) forceps to enable a safe and reliable tissue specimen collection within the proximal biliary tract with cytology brushings in patients with suspected malignant proximal biliary strictures.


Condition Intervention
Cholangiocarcinoma
Device: double-balloon enteroscopy forceps biopsy
Device: Transpapillary brush cytology

Study Type: Interventional
Study Design: Allocation: Non-Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Diagnostic
Official Title: A Combination of Endoscopic Transpapillary Brush Cytology and a Novel Method of Forceps Biopsy to Diagnose Proximal Biliary Malignancies

Resource links provided by NLM:


Further study details as provided by University of Ulm:

Primary Outcome Measures:
  • Biopsy versus brush cytology for diagnosing CCC [ Time Frame: 6 months ] [ Designated as safety issue: No ]
    For this study we recruit patients with proximal biliary stenoses, which are suspect for malignancy. An endoscopic retrograde cholangiography (ERC) will be performed on all patients . During ERC all subjects are undergoing both biopsy (using a double-balloon enteroscopy [DBE] forceps under a guidance of a pusher and guiding catheter with guidewire) and transpapillary brush cytology. The definite clinical diagnosis will be compared to cytological/histological results obtained by biopsy/cytology and accuracy will be evaluated.


Enrollment: 43
Study Start Date: January 2006
Study Completion Date: July 2009
Primary Completion Date: July 2009 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Malignant biliary disease Device: double-balloon enteroscopy forceps biopsy
An endoscopic retrograde cholangiography (ERC) with a duodenoscope Olympus TFJ 160-R (Olympus Corp., Tokyo, Japan) and endoscopic sphincterotomy with an Olympus papillotome (Olympus) is performed under analgosedation . Then, the cannulation of the bile duct is performed by a pusher using a guidewire/guiding catheter. Subsequently, 2 histology samples are taken via a double-balloon enteroscopy (DBE) forceps (BF1725DF, Fujinon GmbH, Willich, Germany), which is placed under the guidance of the pusher.
Device: Transpapillary brush cytology
An endoscopic retrograde cholangiography (ERC) with a duodenoscope Olympus TFJ 160-R (Olympus Corp., Tokyo, Japan) and endoscopic sphincterotomy with an Olympus papillotome (Olympus) is performed under analgosedation . The region of interest is then brushed five times in both directions to obtain cytology specimen.
Experimental: Benign biliary disease Device: double-balloon enteroscopy forceps biopsy
An endoscopic retrograde cholangiography (ERC) with a duodenoscope Olympus TFJ 160-R (Olympus Corp., Tokyo, Japan) and endoscopic sphincterotomy with an Olympus papillotome (Olympus) is performed under analgosedation . Then, the cannulation of the bile duct is performed by a pusher using a guidewire/guiding catheter. Subsequently, 2 histology samples are taken via a double-balloon enteroscopy (DBE) forceps (BF1725DF, Fujinon GmbH, Willich, Germany), which is placed under the guidance of the pusher.
Device: Transpapillary brush cytology
An endoscopic retrograde cholangiography (ERC) with a duodenoscope Olympus TFJ 160-R (Olympus Corp., Tokyo, Japan) and endoscopic sphincterotomy with an Olympus papillotome (Olympus) is performed under analgosedation . The region of interest is then brushed five times in both directions to obtain cytology specimen.

  Eligibility

Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • biliary stenosis with suspected malignancy

Exclusion Criteria:

  • no definite diagnosis available
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT01145248

Locations
Germany
Department of Internal Medicine I, Ulm University Hospital
Ulm, BW, Germany, 89081
Sponsors and Collaborators
University of Ulm
Heidelberg University
Investigators
Principal Investigator: Hasan Kulaksiz, Professor Department of Internal Medicine I, Ulm University Hospital
  More Information

No publications provided

Responsible Party: Professor Hasan Kulaksiz, Department of Internal Medicine I, Ulm University
ClinicalTrials.gov Identifier: NCT01145248     History of Changes
Other Study ID Numbers: BilBiop_001
Study First Received: June 14, 2010
Last Updated: June 15, 2010
Health Authority: Germany: Federal Institute for Drugs and Medical Devices

Keywords provided by University of Ulm:
Cholangiocellular Carcinoma

Additional relevant MeSH terms:
Cholangiocarcinoma
Adenocarcinoma
Carcinoma
Neoplasms, Glandular and Epithelial
Neoplasms by Histologic Type
Neoplasms

ClinicalTrials.gov processed this record on April 14, 2014