Digestive Diseases and Sciences

, Volume 64, Issue 1, pp 241–248 | Cite as

Diagnostic Ability of Endoscopic Bile Cytology Using a Newly Designed Biliary Scraper for Biliary Strictures

  • Kazunari NakaharaEmail author
  • Yosuke Michikawa
  • Ryo Morita
  • Keigo Suetani
  • Nozomi Morita
  • Junya Sato
  • Kensuke Tsuji
  • Hiroki Ikeda
  • Kotaro Matsunaga
  • Tsunamasa Watanabe
  • Nobuyuki Matsumoto
  • Shinjiro Kobayashi
  • Takehito Otsubo
  • Fumio Itoh
Original Article



A new device with metallic wires for scrape cytology was developed.


To compare the diagnostic performance of scrape cytology and conventional cytology during endoscopic retrograde cholangiopancreatography for biliary strictures.


A total of 420 cases with biliary stricture underwent transpapillary bile cytology. Among them, there are 79 cases with scrape cytology using the new device (scrape group) and 341 cases with conventional cytology (control group). Seventy-two and 174 cases underwent biliary biopsy at the same time as bile cytology in the scrape and control group, respectively.


The sensitivity for malignancy of bile cytology in the scrape and control group was 41.2% [pancreatic cancer (PC): 23.1%, biliary cancer (BC): 52.5%] and 27.1% (PC: 16.3%, BC: 38.0%), respectively (P = 0.023). When analyzed PC and BC, respectively, there was no significant difference between the two groups. In the both groups, the sensitivity was significantly higher for BC than PC. In the scrape group, there was no difference in the sensitivity between cytology and biopsy [39.7% (PC: 17.4%, BC: 55.3%)], but in the control group, a significantly lower sensitivity was observed with cytology than biopsy (36.4% (PC: 19.7%, BC: 50.0%)) (P = 0.046). When analyzed PC and BC, respectively, there was no significant difference between cytology and biopsy. The sensitivity of combined cytology and biopsy was 55.6% (PC: 30.4%, BC: 71.1%) in the scrape group and 47.0% (PC: 24.6%, BC: 64.3%) in the control group.


Scrape bile cytology for biliary strictures may be superior to conventional cytology.


Endoscopic retrograde cholangiopancreatography Bile cytology Brush cytology Biliary biopsy Biliary stricture 



The authors report that no financial support for this study was provided.

Compliance with ethical standards

Conflict of interest

Authors declare no conflict of interests for this article.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Kazunari Nakahara
    • 1
    Email author
  • Yosuke Michikawa
    • 1
  • Ryo Morita
    • 1
  • Keigo Suetani
    • 1
  • Nozomi Morita
    • 1
  • Junya Sato
    • 1
  • Kensuke Tsuji
    • 1
  • Hiroki Ikeda
    • 1
  • Kotaro Matsunaga
    • 1
  • Tsunamasa Watanabe
    • 1
  • Nobuyuki Matsumoto
    • 1
  • Shinjiro Kobayashi
    • 2
  • Takehito Otsubo
    • 2
  • Fumio Itoh
    • 1
  1. 1.Department of Gastroenterology and HepatologySt. Marianna University School of MedicineKawasakiJapan
  2. 2.Department of Gastroenterogical and General SurgerySt. Marianna University School of MedicineKawasakiJapan

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