Reliability and accuracy of a novel classification system using peroral cholangioscopy for the diagnosis of bile duct lesions

Robles-Medranda, Carlos; Valero, Manuel; Soria-Alcívar, Miguel; Puga-Tejada, Miguel; Oleas, Roberto; Ospina-Arboleda, Jesenia; Alvarado-Escobar, Haydee; Baquerizo-Burgos, Jorge; Robles-Jara, Carlos; Pitanga-Lukashok, Hannah

doi:10.1055/a-0607-2534

Cited by 68 publications

(67 citation statements)

References 15 publications

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“…▶ Digital POCS confers higher sensitivity and specificity for defining biliary strictures than histologic methods or other cholangioscopy approaches [7,12,13]. Shah et al performed a retrospective analysis of 77 cases with indeterminate stricture or bile duct dilation.…”

Section: Discussionmentioning

confidence: 99%

“…The overall visual impression was determined according to our previously reported proposed classification [7], and histological evaluation and/or 6-month follow-up were considered the gold standard. Univariable and multivariable analyses were performed to determine the risk factors associated with partial biliary stone clearance by EHL in patients with complicated biliary stones.…”

Section: Outcome Measurementsmentioning

confidence: 99%

“…Type 2 "polypoid pattern", were considered a) adenoma or b) granuloma pattern without vascularity. Type 3 "inflammatory pattern" were regular or irregular fibrous and congestive pattern with regular vascularity [7].…”

Section: Pocs Macroscopic Classification Systemmentioning

confidence: 99%

“…Type 3 "ulcerated pattern" were irregular ulcerated and infiltrative pattern with or without fibrosis and with irregular or spider vascularity. A fibrous honeycomb pattern with or without irregular or spider vascularity was considered as type 4 "honeycomb pattern" [7].…”

Section: Pocs Macroscopic Classification Systemmentioning

confidence: 99%

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Digital per-oral cholangioscopy to diagnose and manage biliary duct disorders: a single-center retrospective study

et al. 2020

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Background and study aims Digital, per-oral cholangioscopy (POCS) allows diagnosis of biliary ducts disorders and treatment for complicated stones. We aimed to determine the diagnostic accuracy of digital POCS systems for stricture lesions and the factors precluding complete biliary stone clearance. Patients and methods We performed a retrospective analysis of a prospective database of 265 consecutive patients referred for POCS between December 2016 and July 2018. We first analyzed the diagnostic accuracy of digital POCS for malignant and benign stricture lesions in 147 patients. Then, we analyzed the factors associated with complete or partial biliary stone clearance achieved with electrohydraulic lithotripsy (EHL) delivered via POCS in 118 patients. Results In the diagnostic group, digital POCS achieved 91 % visual-impression sensitivity, 99 % specificity, 99 % positive and 91 % negative predictive values, and 63.64 positive and 0.09 negative likelihood ratios for malignancy diagnosis. In the therapeutic group, complete biliary stone clearance was achieved by EHL in 94.9 % patients; the mean stone size was 20 mm (10–40 mm). In multivariable analyses, a stone size > 20 mm (OR: 1.020, P < 0.001) and the number of stones ≥ 3 (OR: 1.276, P < 001) was associated with partial biliary stone clearance. Adverse events were reported in 3.3 % patients; no deaths were reported 30 days after the procedure. Conclusions Digital POCS has excellent diagnostic efficacy for biliary lesions. EHL via POCS is effective for complicated biliary stone clearance. Stone size (> 20 mm) and the number of stones (≥ 3) are associated with partial biliary stone clearance.

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Section: Discussionmentioning

confidence: 99%

Section: Outcome Measurementsmentioning

confidence: 99%

Section: Pocs Macroscopic Classification Systemmentioning

confidence: 99%

Section: Pocs Macroscopic Classification Systemmentioning

confidence: 99%

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Digital per-oral cholangioscopy to diagnose and manage biliary duct disorders: a single-center retrospective study

et al. 2020

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“…eine Untersucherübereinstimmung von nur 45 % auf [27]. Ende letzten Jahres wurde eine neue Klassifikation vorgeschlagen, die, zumindest unter Experten, eine Übereinstimmung von über 80 % aufwies [28]. Prospektive, multizentrische Studien zur Validierung sind dazu noch ausstehend.…”

Section: Cholangioskopieunclassified

Endoskopische Diagnostik der unklaren Gallengangsstenose: Aktueller Stand und Ausblick

et al. 2019

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ZusammenfassungPatienten mit unklarer Gallengangsstenose stellen regelhaft eine Herausforderung an den klinisch tätigen Gastroenterologen dar. So sollten Patienten mit malignen und potenziell resektablen Erkrankungen so bald wie möglich einer kurativen Operation zugeführt werden. Gleichzeitig sollte bei Patienten mit benignen und potenziell konservativ behandelbaren Erkrankungen eine umfangreiche Operation vermieden werden. Diese Arbeit soll eine Übersicht vermitteln über die Aussagekraft der zurzeit verfügbaren endoskopischen Diagnostik sowie einen Ausblick geben auf potenziell in der Zukunft relevante Verfahren.

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A novel peroral digital cholangioscope with a large accessory channel: An experimental study

Tonozuka

Itoi

Nagai

et al. 2022

J Hepato Biliary Pancreat

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Endoscopic retrograde cholangiopancreatography (ERCP) is among the essential imaging modalities for diagnosis and treatment of biliary disorders. However, it is sometimes difficult to diagnose and treat patients using only indirect two-dimensional images obtained by fluoroscopic imaging. In such cases, a peroral cholangioscope (POCS) can be used to insert an endoscope into the bile duct for direct visualization. [1][2][3][4] Use of the POCS has been increasing due to improvements in functionality, image quality, and operability as well as the development of related devices. The POCS methodology is divided into two main types: one using the "mother-baby" peroral cholangioscope (MB-POCS), in which an ultra-thin scope with an outer diameter of 3.5-4.0 mm is inserted via the transpapillary route through the accessory channel of a sideviewing duodenoscope; 5-7 and the other using a peroral

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Reliability and accuracy of a novel classification system using peroral cholangioscopy for the diagnosis of bile duct lesions

Abstract: The novel classification system could help physicians to distinguish non-neoplastic from neoplastic bile duct lesions.

Cited by 68 publications

References 15 publications

Digital per-oral cholangioscopy to diagnose and manage biliary duct disorders: a single-center retrospective study

Digital per-oral cholangioscopy to diagnose and manage biliary duct disorders: a single-center retrospective study

Endoskopische Diagnostik der unklaren Gallengangsstenose: Aktueller Stand und Ausblick

A novel peroral digital cholangioscope with a large accessory channel: An experimental study

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