Digital cholangioscopy: the diagnostic yield and impact on management of patients with biliary stricture
Jazyk angličtina Země Anglie, Velká Británie Médium print-electronic
Typ dokumentu časopisecké články
- Klíčová slova
- Biliary stricture, cholangiocarcinoma, digital single-operator cholangioscopy,
- MeSH
- biopsie MeSH
- chirurgie žlučových cest přístrojové vybavení metody MeSH
- cholangiografie přístrojové vybavení metody MeSH
- design vybavení MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- nemoci žlučových cest diagnóza chirurgie MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- senzitivita a specificita MeSH
- stenóza diagnóza etiologie MeSH
- výsledek terapie MeSH
- žlučové cesty intrahepatální * MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Česká republika MeSH
OBJECTIVES: Biliary strictures frequently present a diagnostic challenge. The aim of this study was to evaluate the impact of digital single-operator cholangioscopy (DSOC) on subsequent treatment of patients with biliary stricture. METHODS: Consecutive patients undergoing DSOC for biliary stricture were enrolled. Gold standard for final diagnosis included histology from surgical resection. In patients without surgery, clinical evaluation methods and repeated imaging studies were used for comparison of DSOC findings and final diagnosis. Patients were followed-up prospectively focusing on subsequent treatment. RESULTS: Among 30 enrolled patients, final diagnosis was malignant in 13 (43%) and benign in 17 (57%). The sensitivity and specificity of visual impression in diagnosing malignant stricture were 100% (95% CI: 75 - 100) and 76% (95% CI: 50 - 93), respectively. The sensitivity and specificity for biopsy were 92% (95% CI: 62 - 100) and 100% (95% CI: 78 - 100), respectively. One (3%) case of complicating cholangitis with fatal outcome occurred. Final treatment included surgery in 7 (23%), endoscopy in 18 (60%) and chemotherapy in 3 (10%) of patients. CONCLUSIONS: In this study, favorable operating characteristics of DSOC were confirmed. Absolute negative predictive value of visual impression provided reassurance to patients with benign strictures who avoided unnecessary surgery in 53%. One (3%) case of cholangitis with fatal outcome occurred.
Department of Gastroenterology Vitkovice Hospital Czech Republic
e Department of Gastroenterology and Hepatology Klinikum Spandau Berlin Germany
Citace poskytuje Crossref.org
Endoscopic Perspective in Cholangiocarcinoma Diagnostic Process
