Giris ve Amaç: Endoskopik retrograd kolanjiografi sirasinda malignite kuskusu olusturan proksimal biliyer darliklarda taniya ulasmak için en sik olarak endoskopik biyopsi alma yöntemi kullanilir. Ancak bazi olgularda biyopsi forsepsini darlik seviyesine ilerletmek imkansiz olabilmektedir. Bu çalismada amaç, proksimal biliyer darlikli olgularda yeni bir endoskopik biyopsi yönteminin etkinligini prospektif olarak degerlendirmektir. Gereç ve Yöntem: Kasim 2013-Haziran 2015 tarihleri arasinda, Ege Üniversitesi Tip Fakültesi endoskopik retrograd kolanjiopankreatografi ünitesinde proksimal biliyer darlik nedeniyle endoskopik biyopsi alma isleminin uygulandigi hastalar çalismaya dahil edildi. Endoskopik biyopsi islemi stent itici içinden ilerletilen bir biyopsi forsepsi ile yapildi. Hastalarin tüm tibbi kayitlari irdelendi. Bulgular: Toplam 9 hasta [6 erkek, 3 kadin, yas ortalamasi: 65.2 (58-73) yil] çalismaya dahil edildi. Hastalarin nihai tanilari kolanjiokarsinom (Klatskin tümörü) (n=6), safra kesesi karsinomu (n=2) ve post-operatif benign biliyer darlik (n=1) olarak saptandi. Klatskin tümörü ve safra kesesi karsinomu tanili hastalarin tamaminda endoskopik biyopsi spesmenlerinin histopatolojik inceleme sonucu adenokarsinom olarak rapor edildi. Sonuç: Proksimal biliyer darlikli olgularda stent itici içinden ilerletilen biyopsi forsepsi ile uygulanan endoskopik biyopsi metodu histopatolojik taniya ulasmada etkilidir.
Background and Aims: Endoscopic biopsy is the most commonly used technique to reach a diagnosis in patients with suspected proximal biliary malignancies during endoscopic retrograde cholangiography. However, it may be impossible to advance the standard biopsy forceps to the stricture level in some cases. The aim of this study was to prospectively evaluate the effectivity of a new endoscopic biopsy method for patients with proximal biliary strictures. Materials and Methods: Patients with proximal biliary strictures who underwent an endoscopic biopsy procedure in endoscopic retrograde cholangiopancreatography unit of Ege University Medical School between November 2013 and June 2015 were enrolled in the study. Endoscopic biopsy procedure was performed with a biopsy forceps which was advancing through a stent pusher. All of the medical records of the patients were reviewed. Results: A total of 9 patients [6 male, 3 female; mean age: 65.2 (58- 73) years] were enrolled in the study. Final diagnosis was cholangiocarcinoma (Klatskin tumour), gall bladder carcinoma, and post-operative benign biliary stricture in 6, 2, and 1 patients, respectively. Histopathological examinations of the endoscopic biopsy specimens revealed adenocarcinoma in all patients with Klatskin tumour and gall bladder carcinoma. Conclusions: The presented endoscopic biopsy method using biopsy forceps through the stent pusher is effective to achieve a histopathological diagnosis in patients with proximal biliary strictures.