BACKGROUND: The accurate diagnosis of biliary strictures remains problematic. The aim of the present study was to prospectively evaluate the clinical utility of probe-based confocal laser endomicroscopy (pCLE) under the direct view of peroral cholangioscopy (POCS) for the diagnosis of biliary strictures. METHODS: Consecutive patients with biliary strictures were included. We investigated sensitivity, specificity, and accuracy to diagnose malignancy for (1) ERCP alone, (2) POCS, (3) pCLE under the direct view of POCS, and (4) tissue sampling under the direct view of POCS. RESULTS: A total of 30 patients (17 with malignant lesions) were prospectively enrolled. (1) ERCP alone showed 88.2% sensitivity, 46.2% specificity, and 70% (95% confidence interval (CI), 52.1%-83.3%) accuracy. (2) POCS showed 100% sensitivity, 76.9% specificity, and 90% (95% CI, 74.4%-96.5%) accuracy. (3) pCLE under the direct view of POCS showed 94.1% sensitivity, 92.3% specificity, and 93.3% (95% CI, 78.7%-98.8%) accuracy. (4) Tissue sampling under the direct view of POCS showed 82.4% sensitivity, 100% specificity, and 90% (95% CI, 74.4%-96.5%) accuracy. CONCLUSIONS: pCLE under the direct view of POCS provided highly accurate and sensitive characterization of biliary strictures and showed the potential for more diagnostic reliability and reduction of delays in diagnosis. This trial was registered at UMIN (registration number: UMIN000033801).
BACKGROUND: The accurate diagnosis of biliary strictures remains problematic. The aim of the present study was to prospectively evaluate the clinical utility of probe-based confocal laser endomicroscopy (pCLE) under the direct view of peroral cholangioscopy (POCS) for the diagnosis of biliary strictures. METHODS: Consecutive patients with biliary strictures were included. We investigated sensitivity, specificity, and accuracy to diagnose malignancy for (1) ERCP alone, (2) POCS, (3) pCLE under the direct view of POCS, and (4) tissue sampling under the direct view of POCS. RESULTS: A total of 30 patients (17 with malignant lesions) were prospectively enrolled. (1) ERCP alone showed 88.2% sensitivity, 46.2% specificity, and 70% (95% confidence interval (CI), 52.1%-83.3%) accuracy. (2) POCS showed 100% sensitivity, 76.9% specificity, and 90% (95% CI, 74.4%-96.5%) accuracy. (3) pCLE under the direct view of POCS showed 94.1% sensitivity, 92.3% specificity, and 93.3% (95% CI, 78.7%-98.8%) accuracy. (4) Tissue sampling under the direct view of POCS showed 82.4% sensitivity, 100% specificity, and 90% (95% CI, 74.4%-96.5%) accuracy. CONCLUSIONS: pCLE under the direct view of POCS provided highly accurate and sensitive characterization of biliary strictures and showed the potential for more diagnostic reliability and reduction of delays in diagnosis. This trial was registered at UMIN (registration number: UMIN000033801).
Authors: Peter B Cotton; Glenn M Eisen; Lars Aabakken; Todd H Baron; Matt M Hutter; Brian C Jacobson; Klaus Mergener; Albert Nemcek; Bret T Petersen; John L Petrini; Irving M Pike; Linda Rabeneck; Joseph Romagnuolo; John J Vargo Journal: Gastrointest Endosc Date: 2010-03 Impact factor: 9.427
Authors: Michelle A Anderson; Vasu Appalaneni; Tamir Ben-Menachem; G Anton Decker; Dayna S Early; John A Evans; Robert D Fanelli; Deborah A Fisher; Laurel R Fisher; Norio Fukami; Joo Ha Hwang; Steven O Ikenberry; Rajeev Jain; Terry L Jue; Khalid Khan; Mary Lee Krinsky; Phyllis M Malpas; John T Maple; Ravi N Sharaf; Amandeep K Shergill; Jason A Dominitz; Brooks D Cash Journal: Gastrointest Endosc Date: 2012-12-07 Impact factor: 9.427
Authors: Alexander Meining; Yang K Chen; Douglas Pleskow; Peter Stevens; Raj J Shah; Ram Chuttani; Joel Michalek; Adam Slivka Journal: Gastrointest Endosc Date: 2011-07-29 Impact factor: 9.427
Authors: Alexander Meining; Eckart Frimberger; Valentin Becker; Stefan Von Delius; Claus Hann Von Weyhern; Roland M Schmid; Christian Prinz Journal: Clin Gastroenterol Hepatol Date: 2008-07-17 Impact factor: 11.382