Diagnostic value of peroral cholangioscopy in addition to computed tomography for indeterminate biliary strictures View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2021-08-09

AUTHORS

Yukiko Shima, Harutoshi Sugiyama, Sadahisa Ogasawara, Motoyasu Kan, Shikiko Maruta, Toshihito Yamada, Yoshifumi Miura, Kosho Asano, Miyuki Sensui, Hiroki Nagashima, Masayuki Yokoyama, Yuko Kusakabe, Shin Yasui, Izumi Ohno, Rintaro Mikata, Toshio Tsuyuguchi, Takuro Horikoshi, Takashi Mishima, Satoshi Kuboki, Tsukasa Takayashiki, Masayuki Ohtsuka, Jun Kato, Naoya Kato

ABSTRACT

BackgroundPeroral cholangioscopy (POCS) has been used to overcome the difficulty in diagnosing indeterminate biliary stricture or tumor spread. However, the value of adding POCS to computed tomography (CT) remains unclear. Our aim was to evaluate the diagnostic value of adding POCS to CT for indeterminate biliary stricture and tumor spread by interpretation of images focusing on the high diagnostic accuracy of visual findings in POCS.MethodsWe retrospectively identified 52 patients with biliary stricture who underwent endoscopic retrograde cholangiography (ERC) at our institution between January 2013 and December 2018. Two teams, each composed of an expert endoscopist and surgeon, performed the interpretation independently, referring to the CT findings of the radiologist. The CT + ERC + POCS images (POCS group) were evaluated 4 weeks after the evaluation of CT + ERC images (CT group). A 5-point scale (1: definitely benign to 5: definitely malignant) was used to determine the confident diagnosis rate, which was defined as an evaluation value of 1 or 5. Tumor spread was also evaluated.ResultsIn the evaluation of 45 malignant diagnoses, the score was significantly closer to 5 in the POCS group than in the CT group in both teams (P < 0.001). The confident diagnosis rate was significantly higher for the POCS group (92% and 73%) than for the CT group (25% and 12%) in teams 1 and 2, respectively (P < 0.001). We found no significant difference in diagnostic accuracy for tumor spread between the groups.ConclusionVisual POCS findings confirmed the diagnosis of biliary strictures. POCS was useful in cases of indefinite diagnosis of biliary strictures by CT. More... »

PAGES

3408-3417

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00464-021-08661-1

DOI

http://dx.doi.org/10.1007/s00464-021-08661-1

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1140291726

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/34370123


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    "description": "BackgroundPeroral cholangioscopy (POCS) has been used to overcome the difficulty in diagnosing indeterminate biliary stricture or tumor spread. However, the value of adding POCS to computed tomography (CT) remains unclear. Our aim was to evaluate the diagnostic value of adding POCS to CT for indeterminate biliary stricture and tumor spread by interpretation of images focusing on the high diagnostic accuracy of visual findings in POCS.MethodsWe retrospectively identified 52 patients with biliary stricture who underwent endoscopic retrograde cholangiography (ERC) at our institution between January 2013 and December 2018. Two teams, each composed of an expert endoscopist and surgeon, performed the interpretation independently, referring to the CT findings of the radiologist. The CT\u2009+\u2009ERC\u2009+\u2009POCS images (POCS group) were evaluated 4\u00a0weeks after the evaluation of CT\u2009+\u2009ERC images (CT group). A 5-point scale (1: definitely benign to 5: definitely malignant) was used to determine the confident diagnosis rate, which was defined as an evaluation value of 1 or 5. Tumor spread was also evaluated.ResultsIn the evaluation of 45 malignant diagnoses, the score was significantly closer to 5 in the POCS group than in the CT group in both teams (P\u2009<\u20090.001). The confident diagnosis rate was significantly higher for the POCS group (92% and 73%) than for the CT group (25% and 12%) in teams 1 and 2, respectively (P\u2009<\u20090.001). We found no significant difference in diagnostic accuracy for tumor spread between the groups.ConclusionVisual POCS findings confirmed the diagnosis of biliary strictures. POCS was useful in cases of indefinite diagnosis of biliary strictures by CT.", 
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