Bile Duct Brush Cytology - Challenges, Limitations and Ancillary Studies
Juniper Online Journal of Immuno Virology
Brush cytology of the bile duct, pancreatic duct, common bile duct and the ampulla has become an established tool in evaluating obstructive biliary strictures and masses since mid 1970s. Cytology remains the initial choice in determining the precise nature preoperatively, especially because of the unwanted complications that follow the biopsy of these lesions. Most benign strictures are managed by ductal dilatation or stenting while for the malignant strictures Whipple resection or bile duct
... ion or bile duct resection is undertaken when operable. Therefore, confirmation of the benign or malignant nature of the stricture is of prime clinical importance. Recognition of certain key features on cytology can help categorise these cases into suitable definitive categories and thus help the clinicians to better and timely manage patients. The cytology of the biliary tract has a high specificity, but its sensitivity is quite poor. Growing wealth of ancillary tests can be utilised with the indeterminate cytology results to facilitate patient outcome.