scholarly journals The Role of Peroral Cholangioscopy in Evaluating Indeterminate Biliary Strictures

2019 ◽  
Vol 52 (6) ◽  
pp. 556-564 ◽  
Author(s):  
Nasim Parsa ◽  
Mouen A. Khashab
Keyword(s):  
Biliary Strictures ◽  
Peroral Cholangioscopy

scholarly journals Role of Peroral Cholangioscopy for Diagnosis and Staging of Biliary Tumors

2020 ◽  
Vol 38 (5) ◽  
pp. 431-440 ◽  
Author(s):  
Pedro Pereira ◽  
Sancha Santos ◽  
Rui Morais ◽  
Rui Gaspar ◽  
Eduardo Rodrigues-Pinto ◽  
...  
Keyword(s):  
Preoperative Evaluation ◽  
Preoperative Staging ◽  
Final Diagnosis ◽  
Filling Defect ◽  
Biliary Strictures ◽  
Visualization System ◽  
Peroral Cholangioscopy ◽  
Impression Accuracy ◽  
Tertiary Center

Objectives: Peroral cholangioscopy (POC) has shown to be a useful diagnostic procedure in the evaluation of biliary strictures; however, data regarding its role on preoperative staging are scarce. The aim of this study was to evaluate POC role in the diagnosis and preoperative intraductal staging of perihilar cholangiocarcinoma (CCA). Methods: Retrospective study that included all patients who underwent POC with SpyGlassTM Direct Visualization System for the diagnosis of biliary strictures or for preoperative evaluation of extrahepatic biliary tumors, between 2015 and 2019, in a single tertiary center. Results: Forty-three patients were included, 63% male with a median age of 62 years. Thirty-eight (88.3%) underwent POC due to indeterminate biliary strictures, 3 (7%) due to bile duct filling defect, and 2 (4.7%) for intraductal staging of perihilar CCA. In the follow-up, a final diagnosis of malignancy was established in 56% of the patients. Visual impression accuracy with SpyGlass was 95.1% (with 100% sensitivity and 89.5% specificity). SpyBite biopsies accuracy was 80.5% (63.6% sensitivity and 100% specificity). In the 19 patients with a final perihilar CCA diagnosis, intraductal evaluation with SpyGlass altered anatomic classification (Bismuth-Corlette) defined by previous imagiologic findings in 8 (42.1%) patients. Alteration in anatomic classification changed therapeutic approach in 4 (21%). Conclusions: POC use for evaluating intraductal spread in potentially resectable perihilar CCA can detect more extensive and change surgical management. In the future, preoperative staging of perihilar CCA with POC combined with imagiologic evaluation of vascular extension of the lesions may optimize surgical results.

THE ROLE OF “ROSE” FOR ERCP-GUIDED BRUSHING ON INDETERMINATE BILIARY STRICTURES: EXPERIENCE OF A REFERRAL CENTER

2019 ◽  
Author(s):  
L Archibugi ◽  
A Mariani ◽  
B Ciambriello ◽  
MC Petrone ◽  
G Rossi ◽  
...  
Keyword(s):  
Biliary Strictures ◽  
Referral Center

Sa1506 PerOral Cholangioscopy for the Evaluation of Indeterminate Biliary Strictures: A Single Center Experience

2011 ◽  
Vol 73 (4) ◽  
pp. AB191
Author(s):  
Pari M. Shah ◽  
Supriya Rao ◽  
Gregory G. Ginsberg ◽  
Nuzhat A. Ahmad ◽  
David L. Jaffe ◽  
...  
Keyword(s):  
Single Center ◽  
Biliary Strictures ◽  
Peroral Cholangioscopy ◽  
Single Center Experience

scholarly journals Role of Fully Covered Self-Expandable Metal Stent for Treatment of Benign Biliary Strictures and Bile Leaks

2012 ◽  
Vol 13 (Suppl 1) ◽  
pp. S67 ◽  
Author(s):  
Nonthalee Pausawasadi ◽  
Tanassanee Soontornmanokul ◽  
Rungsun Rerknimitr
Keyword(s):  
Metal Stent ◽  
Biliary Strictures ◽  
Benign Biliary Strictures ◽  
Bile Leaks ◽  
Self Expandable Metal Stent

scholarly journals Limited diagnostic accuracy and clinical impact of single-operator peroral cholangioscopy for indeterminate biliary strictures

Endoscopy ◽  
2019 ◽  
Vol 52 (02) ◽  
pp. 107-114 ◽  
Author(s):  
Adriaan B. de Vries ◽  
Frans van der Heide ◽  
Rinze W. F. ter Steege ◽  
Jan Jacob Koornstra ◽  
Karel T. Buddingh ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Predictive Value ◽  
Patient Management ◽  
Clinical Impact ◽  
Biliary Strictures ◽  
Brush Cytology ◽  
Peroral Cholangioscopy ◽  
Single Operator ◽  
Sensitivity Specificity ◽  
Targeted Biopsies

Abstract Background Single-operator peroral cholangioscopy (sPOCS) is considered a valuable diagnostic modality for indeterminate biliary strictures. Nevertheless, studies show large variation in its characteristics and measures of diagnostic accuracy. Our aim was to estimate the diagnostic accuracy of sPOCS visual assessment and targeted biopsies for indeterminate biliary strictures. Additional aims were: estimation of the clinical impact of sPOCS and comparison of diagnostic accuracy with brush cytology. Methods A retrospective single-center study of adult patients who underwent sPOCS for indeterminate biliary strictures was performed. Diagnostic accuracy was defined as sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). The clinical impact of sPOCS was assessed by review of medical records, and classified according to its influence on patient management. Results 80 patients were included, with 40 % having primary sclerosing cholangitis (PSC). Prior ERCP was performed in 88 %, with removal of a biliary stent prior to sPOCS in 55 %. The sensitivity, specificity, PPV, and NPV for sPOCS visual impression and targeted biopsies were 64 %, 62 %, 41 %, and 84 %, and 15 %, 65 %, 75 %, and 69 %, respectively. The clinical impact of sPOCS was limited; outcome changed management in 17 % of patients. Sequential brush cytology sensitivity, specificity, PPV, and NPV were 47 %, 95 %, 80 %, and 83 %. Conclusions The diagnostic accuracy of sPOCS for indeterminate biliary strictures was found to be inferior to brush cytology, with a low impact on patient management. These findings are obtained from a select patient population with a high prevalence of PSC and plastic stents in situ prior to sPOCS.

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