The Double-Max method: a novel method for gallbladder epithelial biopsy

Post written by Masanori Kobayashi, MD, PhD, from the Department of Gastroenterology and Hepatology, Tokyo Medical and Dental University (TMDU), Tokyo, Japan.


Our work published in the May 2022 issue of VideoGIE describes a novel method for mapping biopsy for perihilar cholangiocarcinoma in which the external sheath of the CytomaxII double-lumen biliary cytology brush (Cook Medical, Bloomington, Ind, USA) and SpyBite Max Biopsy Forceps (Boston Scientific, Natick, Mass, USA) were used. By applying this method, we present a novel biopsy method for gallbladder epithelium in the September issue.

Although it is difficult to differentiate between benign and malignant gallbladder lesions, it is important to confirm histological diagnosis before surgery to determine the appropriate procedure. Histological diagnosis by EUS-guided FNA and endoscopic transpapillary gallbladder drainage has been reported to be useful.

However, these methods have risks and limitations. Our method allows biopsy of the gallbladder epithelium. The biopsy forceps can be used in a retroflex position within the gallbladder, allowing for a greater variety of tissue collection sites. This method is expected to improve the diagnostic sensitivity.

Our method is simple and reliable for biopsy of the gallbladder epithelium, and we encourage everyone to try it.

Kobayashi_figureHistological images. A, H&E staining of the biopsy specimen taken from the gallbladder showed normal cylindrical epithelium with no evidence of malignancy (H&E, orig. mag. ×100). B, Macroscopic image of the surgical specimen showed a large number of yellowish or light brown polyps up to 5 mm at the gallbladder fundus. C, H&E staining of the surgical specimen revealed cholesterol polyps with no malignant findings, consistent with the biopsy results (H&E, orig. mag. ×100).

Read the full article online.

The information presented in Endoscopedia reflects the opinions of the authors and does not represent the position of the American Society for Gastrointestinal Endoscopy (ASGE). ASGE expressly disclaims any warranties or guarantees, expressed or implied, and is not liable for damages of any kind in connection with the material, information, or procedures set forth.

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