Use of catheter-based cholangioscopy in the diagnosis of indeterminate stenosis: a multi-centre experience.
Minerva Gastroenterol (Torino)
; 2022 Mar 08.
Article
em En
| MEDLINE
| ID: mdl-35262304
ABSTRACT
BACKGROUND:
Direct bile ducts visualization through cholangioscopy has gained popularity due to its better diagnostic accuracy than a standard ERCP in indeterminate biliary stricture.AIM:
We aimed to review our catheter-based cholangioscopy interventions in patients with indeterminate biliary stenosis, using the SpyGlass Direct Visualization System (SDVS) and summarize our experience in terms of procedures and results.RESULTS:
we collected 25 consecutive patients with indeterminate biliary stricture over 3 years. The overall procedural success in our cohort amounted to 96% (24/25). If we focus on the diagnostic procedures, the ability to merely visualize the region of interest/lesion and perform biopsy of the lesion was possible in 96 % (24/25) In our cohort localization in the common bile duct (P = 0.03; 95 % CI 0.27-0.96) was found as positive determining factor for diagnosis. Sensitivity, specificity and accuracy for visual diagnosis by SDVS in our cohort were 100, 83.3 and 96 %, respectively. The use of biopsy or obtaining a histological diagnosis to assist in identifying patients with malignant stenosis, to exclude malignancy and to correctly classify diagnosed patients resulted in a sensitivity of 100 %, a specificity of 73% % with an overall accuracy of 94.4 %. Only a mild adverse event (cholangitis, treated conservatively) occurred.CONCLUSIONS:
Today, the SDVS should be considered essential in diagnosing indeterminate biliary strictures, since the procedure is associated with high procedural success in terms of diagnostic accuracy, alters clinical outcome in over 80 % of considered insolvable cases, with an acceptable safety profile.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Tipo de estudo:
Diagnostic_studies
/
Prognostic_studies
Idioma:
En
Ano de publicação:
2022
Tipo de documento:
Article