A Study of Mucosal Sampling for Helicobacter pylori Using‘Two-bite’Technique in Relation to Time-saving

Korean J Gastrointest Endosc > Volume 29(1); 2004 > Article

Korean Journal of Gastrointestinal Endoscopy 2004;29(1): 1-5.

Helicobacter pylori의 진단을 위한 위생검에 있어서‘Two-bite’ Technique의 시간 절약 여부에 관한 연구

배문희·김민형·이준행·손희정·최윤호*·이풍렬·김재준·백승운·유병철·이종철

성균관대학교 의과대학 삼성서울병원 소화기내과, *건강의학센터

A Study of Mucosal Sampling for Helicobacter pylori Using‘Two-bite’Technique in Relation to Time-saving

Mun Hee Bae, M.D., Min Hyung Kim M.D., Jun Haeng Lee, M.D., Hee Jung Son, M.D., Yoon-Ho Choi, M.D.*, Poong-Lyul Rhee, M.D., Jae J. Kim, M.D., Seung Woon Paik, M.D., Byung Cheol Yoo M.D. and Jong Chul Rhee, M.D.

Department of Medicine, Samsung Medical Center, *Health Promotion Center, Sungkyunkwan University School of Medicine, Seoul, Korea

Abstract

Background/Aims:
Multiple passages of biopsy forceps increase wear and tear on both the channel of endoscope and forceps. The two-bite technique can save time in obtaining sufficient specimens and also reduce the wear of the instruments. The aim of this study was to assess prospectively the efficacy of two-bite forceps technique in relation to time-saving.
Methods:
A total 84 patients needed histopathologic diagnosis for Helicobacter pylori were randomized into two groups (one-bite technique: 41 patients, two-bite technique: 43 patients). An experienced endoscopist carried out upper endoscopy and used same biopsy forceps (FB-25K^Ⱂ, Olympus, Tokyo, Japan). Mucosal biopsy specimens were obtained as follow: two from the antrum followed by two from the body. Rebiopsy was done when biopsy specimen was lost. The mean time in obtaining specimens and missing rate were analyzed. An experienced pathologist blinded to the technique of obtaining the samples evaluated the specimens for diameter, depth, crush artifact, and adequacy for histopathologic diagnosis.
Results:
A total 336 specimens were obtained from 84 patients. Of these, 12 (7.0%) samples were missed with the two-bite technique but only 1 (0.6%) with the one-bite technique (p=0.003). Regarding histopathologic evaluation, there were no significant differences between samples taken with the two-bite technique and the one-bite technique. The mean time with two-bite technique (47.6 sec) was compared with one-bite technique (62.6 sec)(p＜0.001). But there was no significant time difference if samples were missing during the process (62.5 sec).
Conclusions:
Although two- bite technique saves the time for biopsy, the main limitation is that there is a significant risk of losing samples. (Korean J Gastrointest Endosc 2004;29:1⁣5)

Key Words: Two-bite technique, Endoscopy, Forceps, Biopsy

주요어: Two-bite technique, 내시경, 겸자, 생검