Transpapillary biopsies and brush cytology from the common bile duct

This study comprises 29 patients with a stricture of the common bile duct of unknown etiology, in whom an attempt was made endoscopically to take a biopsy from the ductal wall, in order to establish the diagnosis. Biopsies were obtained from all patients. Follow-up permitted definite diagnosis in 17 patients, from surgery or biopsy. The endoscopic biopsy diagnosis (malignant/benign) proved to be correct in 10 patients, falsely negative in 4. Two were "uncertain malignant" and 1 "not representative". No false positives were seen. Brush cytology provided no additional information. No complications due to the procedure were seen. The results imply that the procedure might be helpful in the evaluation of these patients.