Efficacy of digital single-operator cholangioscopy in the visual interpretation of indeterminate biliary strictures: a systematic review and meta-analysis

Oliveira, Pedro Victor Aniz Gomes de; Ribeiro, Igor Braga; Bazarbashi, Ahmad Najdat; Franzini, Tomazo; Santos, Marcos Eduardo Lera dos; Bernardo, Wanderley Marques; Moura, Eduardo Guimarães Hourneaux de

doi:10.1007/s00464-020-07583-8

Cited by 43 publications

(31 citation statements)

References 37 publications

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“…The pooled sensitivity, specificity, PLR, NLR and DOR were 0.95 (95% CI: 0.91-0.97), 0.92 (95% CI: 0.88-0.95), 9.29 (95% CI: 5.12-16.86), 0.08 (95% CI: 0.05-0.14) and 178.24 (95% CI: 80.10-396.64), respectively, and the area under the curve (AUC) was 0.9774 ( Figure S1). These findings are consistent with that of previous published articles [8], highlighting the diagnostic value of VI during DSOC.…”

Section: Meta-analysissupporting

confidence: 93%

“…The present systematic review and meta-analysis is the first to comprehensively assess the efficacy and safety of DSOC-guided target biopsies. Previous studies have systematically explored the diagnostic value of VI during DSOC, but not biopsies [8]. The present study discussed the role of both VI and SB.…”

Section: Discussionmentioning

confidence: 92%

“…The present study was conducted according to PRISMA (the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines) guidelines [8].…”

Section: Methodsmentioning

confidence: 99%

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Efficacy and Safety of Digital Single-Operator Cholangioscopy in the Diagnosis of Indeterminate Biliary Strictures by Targeted Biopsies: A Systematic Review and Meta-Analysis

Wen

Chen

et al. 2020

Diagnostics

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Background: Biliary strictures are frequently encountered in clinical practice. The determination of their nature is often difficult. This study aims to systematically evaluate the efficacy and safety of the second generation of digital single-operator cholangioscopy (SpyGlass DS, DSOC) in indeterminate biliary strictures (IBDS) through biopsies. Methods: All relative studies published in Medline, the Cochrane Library, Web of Science, and EMBASE were included. The diagnostic tests for IBDS were compared to the surgical histology, autopsy, or long-term clinical follow-up. The methodological quality of the included studies was evaluated by the Quality Assessment of Studies of Diagnostic Accuracy Included in Systematic Reviews (QUADAS-2). Results: A total of 11 studies, which involved 356 patients diagnosed through biopsies, were included. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and diagnostic odds ratio were 0.74 (95% CI: 0.67–0.80), 0.98 (95% CI: 0.95–1.00), 10.52 (95% CI: 5.45–20.32), 0.31 (95% CI: 0.23–0.41), and 65.18 (95% CI: 26.79–158.61), respectively. The area under the curve (AUC) was 0.9479, and the pooled adverse event rate was 7%. The sensitivity and specificity in the heterogeneity analysis were I2 = 48.1% and I2 = 25.4%, respectively. Conclusion: SpyGlass DS is a safe and effective technique for IBDS. However, future randomized trials are needed to determine optimal number of biopsies.

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Section: Meta-analysissupporting

confidence: 93%

Section: Discussionmentioning

confidence: 92%

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Efficacy and Safety of Digital Single-Operator Cholangioscopy in the Diagnosis of Indeterminate Biliary Strictures by Targeted Biopsies: A Systematic Review and Meta-Analysis

Wen

Chen

et al. 2020

Diagnostics

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“…In patients with prior negative or unconfirmed diagnosis after standard ERCP tissue acquisition, the overall sensitivity, specificity, and accuracy of visual impression were 90-100%, 79-96%, and 89-97%(10) (Table 3). A meta-analysis including 283 patients by de Oliveira et al (11) demonstrated that visual impression to diagnose malignancy made by digital SOC had sensitivity, specificity, accuracy, positive predictive value, negative predictive value, and diagnostic Odds-ratio of 94%, 95%, 94%, 93%, 98%, and 309 respectively.…”

Section: J O U R N a L P R E -P R O O Fmentioning

confidence: 99%

“…An overall sensitivity of 94% was reported for the visual diagnosis of malignant/neoplastic biliary strictures in a systematic review and a meta-analysis (10,11). A systematic review reported that four characteristics (tumor vessels, papillary projection, nodular or polypoid mass, and infiltrative lesions) were commonly used for detection of malignant/neoplastic biliary strictures at cholangioscopy (10).…”

Section: J O U R N a L P R E -P R O O Fmentioning

confidence: 99%

Consensus guidelines on the role of cholangioscopy to diagnose indeterminate biliary stricture

Angsuwatcharakon

Kulpatcharapong

Moon

et al. 2022

HPB

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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Clinical practice guideline on the use of single-operator cholangioscopy in the diagnosis of indeterminate biliary stricture and the treatment of difficult biliary stones

Rey Rubiano,

González-Teshima,

Arango

et al. 2023

Surg Endosc

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Background and aims Single-operator cholangioscopy (SOC) offer a diagnostic and therapeutic alternative with an improved optical resolution over conventional techniques; however, there are no standardized clinical practice guidelines for this technology. This evidence-based guideline from the Colombian Association of Digestive Endoscopy (ACED) intends to support patients, clinicians, and others in decisions about using in adults the SOC compared to endoscopic retrograde cholangiopancreatography (ERCP), to diagnose indeterminate biliary stricture and to manage difficult biliary stones. Methods ACED created a multidisciplinary guideline panel balanced to minimize potential bias from conflicts of interest. Universidad de los Andes and the Colombia Grading of Recommendations Assessment, Development and Evaluation (GRADE) Network supported the guideline-development process, updating and performing systematic evidence reviews. The panel prioritized clinical questions and outcomes according to their importance for clinicians and patients. The GRADE approach was used, including GRADE Evidence-to-Decision frameworks. Results The panel agreed on one recommendation for adult patients with indeterminate biliary strictures and one for adult patients with difficult biliary stones when comparing SOC versus ERCP. Conclusion For adult patients with indeterminate biliary strictures, the panel made a conditional recommendation for SOC with stricture pattern characterization over ERCP with brushing and/or biopsy for sensitivity, specificity, and procedure success rate outcomes. For the adult patients with difficult biliary stones the panel made conditional recommendation for SOC over ERCP with large-balloon dilation of papilla. Additional research is required on economic estimations of SOC and knowledge translation evaluations to implement SOC intervention in local contexts.

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Efficacy of digital single-operator cholangioscopy in the visual interpretation of indeterminate biliary strictures: a systematic review and meta-analysis

Cited by 43 publications

References 37 publications

Efficacy and Safety of Digital Single-Operator Cholangioscopy in the Diagnosis of Indeterminate Biliary Strictures by Targeted Biopsies: A Systematic Review and Meta-Analysis

Efficacy and Safety of Digital Single-Operator Cholangioscopy in the Diagnosis of Indeterminate Biliary Strictures by Targeted Biopsies: A Systematic Review and Meta-Analysis

Consensus guidelines on the role of cholangioscopy to diagnose indeterminate biliary stricture

Clinical practice guideline on the use of single-operator cholangioscopy in the diagnosis of indeterminate biliary stricture and the treatment of difficult biliary stones

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