ERCP—Methods of tissue sampling

There are several methods for obtaining tissue samples from the pancreaticobiliary tract during endoscopic retrograde cholangiopancreatography. Confirmation of histology is often necessary to guide subsequent therapy. In this review, several techniques are described, including exfoliative cytology, brush cytology, endobiliary forceps biopsy, and endobiliary fine-needle aspiration. In addition, digital image analysis and molecular genetic analysis are discussed. This review of all the above tissue sampling and analysis techniques also provides practical advice, and high-lights more recent studies, which suggest that the diagnostic yield from tissue obtained at endoscopic retrograde cholangiopancreatography is increased with multimodal tissue sampling.