Endoscopic Retrograde Cholangiopancreatography Tissue Sampling: When and How?

A 69-year-old man presented with obstructive jaundice. Endoscopic retrograde cholangiopancreatography was performed for biliary tree decompression and diagnostic tissue acquisition. Techniques, indications, methodologic considerations, and interpretation of tissue sampling at endoscopic retrograde cholangiopancreatography in patients with biliary/pancreatic strictures are discussed. This case-based educational presentation focuses on the importance of interdisciplinary communication between endoscopists and pathologists for optimal tissue sampling, interpretation, and diagnostic accuracy.

Abbreviations used in this paper: CBD, common bile duct, DIA, digital image analysis, ERCP, endoscopic retrograde cholangiopancreatography, FISH, fluorescence in situ hybridization, FNA, fine-needle aspiration, PSC, primary sclerosing cholangitis.

⁎ Department of Medicine, Division of Gastroenterology, Hepatology & Nutrition, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania

‡ Department of Anatomic Pathology, Mayo Clinic College of Medicine, Rochester, Minnesota

§ Division of Gastroenterology & Hepatology, Department of Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota

Address requests for reprints to: Todd H. Baron, MD, 200 First St SW, Charlton 8, Rochester, Minnesota 55905. fax: (507)266-3939.

PII: S1542-3565(07)00458-2

doi:10.1016/j.cgh.2007.04.017

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