Intraductal ultrasound substantiates diagnostics of bile duct strictures of uncertain etiology

Meister, Tobias; Heinzow, Hauke; Woestmeyer, Carina; Lenz, Philipp; Menzel, J.; Kucharzik, Torsten; Domschke, Wolfram; Domagk, Dirk

doi:10.3748/wjg.v19.i6.874

Cited by 79 publications

(54 citation statements)

References 25 publications

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“…To further improve the diagnostic yield, advanced endoscopic imaging modalities such as intraductal ultrasound and optical coherence tomography have been applied. A large cohort study of 397 patients showed that intraductal ultrasound had a sensitivity of 93.2%, a specificity of 89.5% and an accuracy of 91.4% for discriminating benign from malignant biliary strictures . However, its diagnostic yield could be affected by prior biliary stenting or other interventions.…”

Section: Resultsmentioning

confidence: 99%

Review article: Asia‐Pacific consensus recommendations on endoscopic tissue acquisition for biliary strictures

Sun¹,

Lee

Cai

et al. 2018

Aliment Pharmacol Ther

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Section: Resultsmentioning

confidence: 99%

Review article: Asia‐Pacific consensus recommendations on endoscopic tissue acquisition for biliary strictures

Sun¹,

Lee

Cai

et al. 2018

Aliment Pharmacol Ther

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“…Furthermore, maneuverability and visualization of POCS are often limited in the very DBS because of the unstable scope position. In a retrospective analysis of 397 cases with indeterminate biliary stricture, IDUS was useful in predicting malignancy with a sensitivity, specificity, and accuracy of 93%, 89%, and 91%, respectively . However, most studies on the utility of IDUS and POCS included both hilar and DBS and did not evaluate their specific use in DBS.…”

Section: Methodsmentioning

confidence: 99%

International consensus statements for endoscopic management of distal biliary stricture

Nakai

Isayama

Wang

et al. 2020

J of Gastro and Hepatol

103

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Distal biliary strictures (DBS) are common and may be caused by both malignant and benign pathologies. While endoscopic procedures play a major role in their management, a comprehensive review of the subject is still lacking. Our consensus statements were formulated by a group of expert Asian pancreatico‐biliary interventional endoscopists, following a proposal from the Digestive Endoscopy Society of Taiwan, the Thai Association for Gastrointestinal Endoscopy, and the Tokyo Conference of Asian Pancreato‐biliary Interventional Endoscopy. Based on a literature review utilizing Medline, Cochrane library, and Embase databases, a total of 19 consensus statements on DBS were made on diagnosis, endoscopic drainage, benign biliary stricture, malignant biliary stricture, and management of recurrent biliary obstruction and other complications. Our consensus statements provide comprehensive guidance for the endoscopic management of DBS.

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“…The diagnostic work‐up of patients presenting with bile duct obstruction remains challenging. There are various malignant diseases that can cause bile duct obstruction including cholangiocarcinoma, adenocarcinoma of the papilla of Vater, pancreatic carcinoma or metastases with consecutive compression of the common bile duct . The clinical characteristic features for malignant bile duct obstruction are variable and often not entirely clear.…”

Section: Introductionmentioning

confidence: 99%

Novel score for prediction of malignant bile duct obstruction based on biochemical and clinical markers

Meister

Uphoff

Heinecke

et al. 2015

Aliment Pharmacol Ther

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Summary Background Early differentiation of malignant from benign bile duct obstruction is of utmost importance. Aim To identify biochemical and clinical predictors for malignancy in patients with bile duct obstruction, and establish a predictive model by combining pre‐treatment patient characteristics. A web‐based application was developed for easy assessment of malignant bile duct probability (http://www.pmal-score.org). Methods One thousand hundred and thirty‐five patients [median age 66 (52–75) years, 53% male] with bile duct obstruction of various aetiologies were retrospectively evaluated at our tertiary referral centre. Multivariate logistic regression analysis identified factors as independently significant for malignant bile duct obstruction. A predictive risk score was established using ROC analysis and applied to an external validation cohort of 101 patients. Results Three hundred and ninety‐four patients had malignant bile duct obstruction proven by surgery, while in 741 patients benign obstruction was observed. Multivariate analysis identified various clinical factors to be predictive for malignancy. On the basis of eight predictors, a risk score for malignancy was developed [X = 0.025 * [age] + 1.239 * [1 if weight loss, otherwise 0] − 0.235 * [1 if pain, otherwise 0] + 0.649 * [1 if diabetes, otherwise 0] + 0.896 * [1 if jaundice, otherwise 0] + 0.109 * [bilirubin] + 0.0007 * [γ‐GT] + 0.0003 * [AP] − 4.374]: A significant correlation between the predicted malignancy and the actual malignancy was found by ROC (AUC: 0.862; 95% CI 0.838–0.886, P < 0.0001). Conclusions This predictive risk score estimates the risk of malignancy in patients with bile duct obstruction, and it seems to be very accurate. A better prediction enables both earlier diagnosis of malignant obstructive disease and improved management of patients with bile duct obstruction, which may result in reduced morbidity and mortality.

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Intraductal ultrasound substantiates diagnostics of bile duct strictures of uncertain etiology

Abstract: IDUS shows good results for accurate diagnostics of bile duct strictures of uncertain etiology thus allowing for adequate further clinical management.

Cited by 79 publications

References 25 publications

Review article: Asia‐Pacific consensus recommendations on endoscopic tissue acquisition for biliary strictures

Review article: Asia‐Pacific consensus recommendations on endoscopic tissue acquisition for biliary strictures

International consensus statements for endoscopic management of distal biliary stricture

Novel score for prediction of malignant bile duct obstruction based on biochemical and clinical markers

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