2011
DOI: 10.1016/j.gie.2011.05.009
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Direct visualization of indeterminate pancreaticobiliary strictures with probe-based confocal laser endomicroscopy: a multicenter experience

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Cited by 191 publications
(146 citation statements)
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References 24 publications
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“…pCLE allows a microscopic evaluation of the biliary epithelium in vivo ( Figure 4). In a study by Meining et al, 16 the sensitivity was 85% for ERCP þ pCLE þ biopsies and only 40% for ERCP alone þ biopsies. Several other studies have shown a significant increase in sensitivity compared to tissue sampling techniques (Table 3) and this has resulted in the development of standardised image interpretation criteria, which have been proven to be highly accurate for the in vivo characterization of biliary lesions.…”
mentioning
confidence: 94%
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“…pCLE allows a microscopic evaluation of the biliary epithelium in vivo ( Figure 4). In a study by Meining et al, 16 the sensitivity was 85% for ERCP þ pCLE þ biopsies and only 40% for ERCP alone þ biopsies. Several other studies have shown a significant increase in sensitivity compared to tissue sampling techniques (Table 3) and this has resulted in the development of standardised image interpretation criteria, which have been proven to be highly accurate for the in vivo characterization of biliary lesions.…”
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confidence: 94%
“…However, histologic confirmation of pancreaticobiliary malignancy provides only limited diagnostic accuracy, with about 50% sensitivity. 16,18,19 The benefits of pCLE to obtain a more accurate characterisation of biliary strictures than with ERCP was strongly acknowledged by the panellists. pCLE allows a microscopic evaluation of the biliary epithelium in vivo ( Figure 4).…”
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confidence: 99%
“…53 A recent study of 102 patients with indeterminate pancreaticobiliary strictures showed that accuracy for combination of ERCP and pCLE was significantly higher compared with ERCP with tissue acquisition (90% vs. 73%; p=0.001). 54 Further studies are required but pCLE may be an important adjunct to current modalities available in the diagnosis of malignant biliary strictures.…”
Section: Pancreatico-biliarymentioning
confidence: 99%
“…103 Another pCLE study that used the older Miami classification showed accuracy of 81%, sensitivity 98%, and specificity 67% compared to accuracy 75%, sensitivity 45%, and specificity 100% of histopathology. 104 The Paris classification was recently validated for the characterization of indeterminate biliary strictures with increase in specificity, no impact in accuracy and fair interobserver variation (Table 3). [103][104][105][106][107] pCLE was also studied in 15 PSC patients with dominant strictures, some of whom had biliary stents in place, and demonstrated a sufficient stricture visualization of 95%, sensitivity 100%, and specificity 61% in detecting neoplasia.…”
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confidence: 99%