Examination of ERCP-based tissue biopsy and EUS-FNA in choledochal stenosis or masses

Objective: It was planned to retrospectively analyze the histopathological diagnoses of patients with stenosis or mass in the common bile duct who underwent only ERCP-based tissue biopsy, and only EUS-FNA or EUS-FNA after ERCP. Patients and Methods: A total of 135 patients with common bile duct stenosis or mass on imaging, who applied between 2015 and 2022, were included in the study. By scanning the patients retrospectively; Patient gender and age, symptoms at presentation, imaging results, stenosis localization, common bile duct width on imaging, final diagnosis result, endoscopic procedure performed, complications due to endoscopic procedure were recorded. Results: The patients had biliary stricture in 28% (n=38), pancreatic mass in 25% (n=34), periampullary mass in 21% (n=29), biliary mass in 13% (n=18) and hilar LAP in 4% (n=6).The sensitivity, specificity, and diagnostic accuracy of ERCP-based tissue samples were 76.62%, 86.84%, and 80%, respectively. The sensitivity, specificity and diagnostic accuracy of EUS-FNA were 97.50%, 58.33% and 88.46%, respectively. Discussion and Conclusion: When the diagnostic performances were compared according to the biliary stricture location, the sensitivity and diagnostic accuracy of EUS-FNA were found to be high in cases with distal stenosis localization, while the specificity of ERCP-based tissue sampling was superior to EUS-FNA. There was no significant difference between the sensitivity and specificity of ERCP and EUS-FNA in cases with proximal stenosis localization. Although there are many studies in the literature investigating the place of ERCP-based tissue biopsies and EUS-FNA in common bile duct stenosis and masses, studies on this subject are limited in our country. For this reason, we think that our study contributes to the country data.