Tissue Yield and Diagnostic Efficacy of Fluoroscopic and Cholangioscopic Techniques to Assess Indeterminate Biliary Strictures

Hartman, Douglas J.; Slivka, Adam; Giusto, Deborah; Krasinskas, Alyssa M.

doi:10.1016/j.cgh.2012.05.025

Cited by 78 publications

(67 citation statements)

References 14 publications

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“…However, only 3 studies specifically reported the role of positive SpyGlass biopsy in the diagnosis of malignant biliary stricture. Of the remaining 7 studies, 2 studies included suspicious biopsies as malignant, 14,17 and the remaining 5 studies 4,5,11,12,16 did not include terminology such as suspicious for cancer in their discussion. The pooled sensitivity and specificity for diagnosis of malignant biliary strictures by cholangioscopy-guided biopsies specifically including positive biopsy results alone was 72.0% (95% CI, 57.0%-84.0%) and 93.0% (95% CI, 82.0%-99.0%), respectively (Supplementary Table 1 and Supplementary Fig.…”

Section: Resultsmentioning

confidence: 99%

Single-operator cholangioscopy and targeted biopsies in the diagnosis of indeterminate biliary strictures: a systematic review

Navaneethan¹,

Hasan²,

Lourdusamy³

et al. 2015

Gastrointestinal Endoscopy

235

170

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Background and Aims Evaluation of indeterminate biliary strictures by brush cytology and intraductal biopsies is limited by low sensitivity. The utility of SpyGlass peroral cholangioscopy for diagnosis of malignant biliary strictures and cholangiocarcinoma (CCA), in particular, remains unclear. Our aim was to study the utility of SpyGlass peroral cholangioscopy and targeted biopsy for diagnosis of malignant biliary strictures and CCA. Methods In this systematic review, PubMed and Embase databases were reviewed for studies published to October 2014. The main outcomes of interest were sensitivity, specificity, and diagnostic odds ratio (DOR) of SpyGlass cholangioscopy in the diagnosis of malignant biliary strictures. Results The search yielded 10 studies involving 456 patients. The pooled sensitivity and specificity of cholangioscopy-guided biopsies in the diagnosis of malignant biliary strictures was 60.1% (95% confidence interval [CI], 54.9%-65.2%) and 98.0% (95% CI, 96.0%-99.0%), respectively. The pooled DOR to detect malignant biliary strictures was 66.4 (95% CI, 32.1-137.5). Four studies included patients who had previous negative imaging and brushings and/or intraductal biopsies. Among these 4 studies, the pooled sensitivity and specificity for diagnosis of malignant biliary strictures was 74.7% (95% CI, 63.3%-84.0%) and 93.3% (95% CI, 85.1%-97.8%), respectively. The pooled DOR was 46.0 (95% CI, 15.4-138.1). Only 1 study directly compared the yield of SpyBite biopsies with standard brushings and biopsies. SpyBite biopsies had a sensitivity of 76.5% compared with brushings (5.8%) and biopsies (29.4%). Six studies specifically reported the role of cholangioscopy with targeted biopsies in the diagnosis of CCA. The pooled sensitivity and specificity to detect CCA was 66.2% (95% CI, 59.7%-72.3%) and 97.0% (95% CI, 94.0%-99.0%), respectively. The pooled DOR to detect CCA was 79.7 (95% CI, 32.7-194.7). Conclusions Our study suggests that SpyGlass cholangioscopy with SpyBite biopsies has moderate sensitivity for the diagnosis of malignant biliary strictures.

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Section: Resultsmentioning

confidence: 99%

Single-operator cholangioscopy and targeted biopsies in the diagnosis of indeterminate biliary strictures: a systematic review

Navaneethan¹,

Hasan²,

Lourdusamy³

et al. 2015

Gastrointestinal Endoscopy

235

170

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“…CRC screening with biannual faecal immunochemical test (FIT) has been shown to reduce CRC mortality and incidence,3 4 and population-based organised screening programmes based on FIT have already been implemented in Italy and the Netherlands 5…”

Section: Introductionmentioning

confidence: 99%

Full-spectrum (FUSE) versus standard forward-viewing colonoscopy in an organised colorectal cancer screening programme

Hassan

Senore

Radaelli

et al. 2016

Gut

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“…and Y.M.). Therefore, 8 studies finally met the inclusion criteria [13][14][15][16][17][18][19][20] (Fig. 1).…”

Section: Literature Searchmentioning

confidence: 99%

Is single-operator peroral cholangioscopy a useful tool for the diagnosis of indeterminate biliary lesion? A systematic review and meta-analysis

Sun

Zhou

Tian

et al. 2015

Gastrointestinal Endoscopy

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Tissue Yield and Diagnostic Efficacy of Fluoroscopic and Cholangioscopic Techniques to Assess Indeterminate Biliary Strictures

Cited by 78 publications

References 14 publications

Single-operator cholangioscopy and targeted biopsies in the diagnosis of indeterminate biliary strictures: a systematic review

Single-operator cholangioscopy and targeted biopsies in the diagnosis of indeterminate biliary strictures: a systematic review

Full-spectrum (FUSE) versus standard forward-viewing colonoscopy in an organised colorectal cancer screening programme

Is single-operator peroral cholangioscopy a useful tool for the diagnosis of indeterminate biliary lesion? A systematic review and meta-analysis

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