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Endoscopy 2020; 52(03): 174-185
DOI: 10.1055/a-1083-6105
Systematic review

Diagnostic performance of different cholangioscopes in patients with biliary strictures: a systematic review

Santi Kulpatcharapong‡   *
1   Division of Gastroenterology, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
,
Rapat Pittayanon‡   *
1   Division of Gastroenterology, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
,
Stephen J. Kerr
2   Department of Research Affairs, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
,
Rungsun Rerknimitr
1   Division of Gastroenterology, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
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Referred to by:

You cannot go wrong: choosing digital single-operator cholangioscopy for the diagnosis of biliary stricturesEndoscopy 2020; 52(03): 168-169
DOI: 10.1055/a-1106-7246

Referred to by:

Author commentary on Santi Kulpatcharapong et al.Endoscopy 2020; 52(03): v9-v9
DOI: 10.1055/a-1082-4092

Abstract

Background Cholangioscopy provides direct intraductual imaging, which can enhance diagnostic efficacy during endoscopic retrograde cholangiopancreatography in patients with biliary strictures. This study aimed to review the diagnostic yield of different cholangioscopes for the diagnosis of malignant biliary stricture (MBS).

Methods A comprehensive literature review was performed. Full papers of prospective studies using any type of peroral cholangioscope (POC) were included without language restriction. The primary outcomes were sensitivity, specificity, and accuracy of various POCs to diagnose MBS.

Results Data from 20 published articles, involving 1141 patients, were extracted. Overall sensitivities of POCs for diagnosing MBS were higher for the diagnosis made under visual impression compared with those from cholangioscopy-guided biopsy (67 % – 100 % vs. 38 % – 100 %), whereas the overall specificities were generally high and comparable (73 % – 100 % vs. 75 % – 100 %). Newer video cholangioscopes (digital single-operator POC [digital SOC], direct POC) with the exception of video dual-operator mother – baby POC (video DOC), provided better sensitivity of cholangioscopy-guided biopsy compared with fiberoptic scopes (digital SOC 80 % – 85 %, direct POC 80 % – 100 %, video DOC 38 % – 100 %, and fiberoptic SOC 49 % – 100 %, respectively). Among these video cholangioscopes, the digital SOC provided the highest technical success rate, at 100 %.

Conclusions POCs enhanced the diagnostic yield for diagnosis of MBS. Compared with fiberoptic POCs that only provide good image impression, the digital SOC and direct POC were good at both image impression and cholangioscopy-guided biopsy to diagnose MBS. To ensure high technical success for MBS diagnosis, the digital SOC is a good option.

* These authors contributed equally to this work.


Supplementary material



Publication History

Received: 26 June 2019

Accepted: 22 November 2019

Article published online:
10 January 2020

© Georg Thieme Verlag KG
Stuttgart · New York

 

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