Biliary brush cytology and biopsy

4. Biliary brush cytology and biopsy

Even though, percutaneous radiologically guided fine needle aspiration (FNA) or biopsy is accurate, this technique may not be feasible to sample small biliary tumours. At the same time, the seeding of the cancer cells in the needle tract constitutes a problem for patients who are candidates for surgery. In such situations endobiliary brush cytology or biopsy is helpful. In this technique, a cytology brush or biopsy forceps is inserted through a vascular sheath placed percutaneously in the biliary tract and the stricture is brushed or sampled to be able to obtain sufficient number of biliary epithelial cells or tissue for cytological evaluation.