Background
The diagnostic accuracy of peroral video-cholangioscopy for indeterminate biliary
lesions has not been determined in a prospective study.
Objective
To evaluate and compare the diagnostic accuracy of the peroral video-cholangioscopic
visual findings for indeterminate biliary lesions with that of the cholangioscopy-guided
forceps biopsy findings.
Design
Prospective cohort study.
Setting
Tertiary-care referral center.
Patients
Patients who showed indeterminate biliary lesions on endoscopic retrograde cholangiography
underwent peroral video-cholangioscopy for diagnosis.
Intervention
Each patient underwent peroral video-cholangioscopy with cholangioscopy-guided forceps
biopsy.
Main Outcome Measurements
The accuracy of diagnosis by the peroral video-cholangioscopic visual findings and
cholangioscopy-guided forceps biopsy findings compared with that of the final diagnosis
by other methods (malignant or benign).
Results
Thirty-three patients were enrolled, and the final diagnoses revealed that the lesions
were malignant in 21 patients. All procedures were technically successful, and fine
views were obtained in all patients. Procedure-related complications occurred in 2
patients (6.1%), but these complications were mild. The sensitivity, specificity,
and accuracy were 100%, 91.7%, and 97.0%, respectively, for the peroral video-cholangioscopic
visual findings and 38.1%, 100%, and 60.6%, respectively, for the cholangioscopy-guided
forceps biopsy findings, and a significant difference was observed in the accuracy
(P = .0018).
Limitations
This was not a blinded study. No comparison was made with other diagnostic modalities
involving tissue sampling.
Conclusion
The diagnostic accuracy of the peroral video-cholangioscopic visual findings for indeterminate
biliary lesions was excellent and significantly higher than that of the cholangioscopy-guided
forceps biopsy findings. The accuracy of the cholangioscopy-guided forceps biopsy
was insufficient, but the technique had an excellent specificity.
Abbreviations:
ERC (endoscopic retrograde cholangiography), PVCS (peroral video-cholangioscopy)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: December 10, 2012
Accepted:
October 5,
2012
Received:
August 1,
2012
Footnotes
DISCLOSURE: All authors disclosed no financial relationships relevant to this publication.
Identification
Copyright
© 2013 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.
