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Diagnostic utility of single-user peroral cholangioscopy in sclerosing cholangitis.

Kalaitzakis, Evangelos LU ; Sturgess, Richard; Kaltsidis, Harry; Oppong, Kofi; Lekharaju, Venkata; Bergenzaun, Per LU ; Vlavianos, Panagiotis; Sharma, Hemant; Westaby, David and Webster, George J (2014) In Scandinavian Journal of Gastroenterology 49(10). p.1237-1244
Abstract
Abstract Objective. To evaluate the diagnostic utility of single-operator peroral cholangioscopy (SOC) in patients with sclerosing cholangitis. Methods. All patients with sclerosing cholangitis who underwent SOC procedures due to suspicious biliary strictures, in one Swedish and four UK tertiary centers in 2008-2012, were retrospectively enrolled. For each SOC procedure in sclerosing cholangitis, another one attempted due to a single biliary stricture in the same center and calendar year was randomly selected as control. Patients were followed up until death or last clinic visit until November 2012. Results. Fifty-four SOC procedures were attempted in 52 sclerosing cholangitis patients (48 with primary sclerosing cholangitis, 4 with... (More)
Abstract Objective. To evaluate the diagnostic utility of single-operator peroral cholangioscopy (SOC) in patients with sclerosing cholangitis. Methods. All patients with sclerosing cholangitis who underwent SOC procedures due to suspicious biliary strictures, in one Swedish and four UK tertiary centers in 2008-2012, were retrospectively enrolled. For each SOC procedure in sclerosing cholangitis, another one attempted due to a single biliary stricture in the same center and calendar year was randomly selected as control. Patients were followed up until death or last clinic visit until November 2012. Results. Fifty-four SOC procedures were attempted in 52 sclerosing cholangitis patients (48 with primary sclerosing cholangitis, 4 with IgG4-related sclerosing cholangitis). Cannulation with the SOC system failed more frequently in sclerosing cholangitis (15% vs. 2% in controls; p = 0.015). The sensitivity, specificity, and accuracy of SOC (including tissue sampling) for cancer diagnosis were similar in sclerosing cholangitis and controls (50% vs. 55%, 100% vs. 97%, and 88% vs. 80%, respectively) with largely overlapping confidence intervals. Adverse events were more common in sclerosing cholangitis, due to an increased frequency of cholangitis (11% vs. 2% in controls; p = 0.051). Conclusions. SOC is equally accurate in cancer diagnosis in sclerosing cholangitis and patients with single biliary strictures. However, cholangioscope insertion may be hampered by bile duct narrowing and post-SOC cholangitis is more common in sclerosing cholangitis. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Scandinavian Journal of Gastroenterology
volume
49
issue
10
pages
1237 - 1244
publisher
Taylor & Francis
external identifiers
  • pmid:25007715
  • wos:000342228700010
  • scopus:84907235578
ISSN
1502-7708
DOI
10.3109/00365521.2014.936032
language
English
LU publication?
yes
id
4523a44a-5a90-44c7-8174-8c091cb9d87f (old id 4583212)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/25007715?dopt=Abstract
date added to LUP
2014-08-07 19:44:27
date last changed
2017-07-30 03:29:11
@article{4523a44a-5a90-44c7-8174-8c091cb9d87f,
  abstract     = {Abstract Objective. To evaluate the diagnostic utility of single-operator peroral cholangioscopy (SOC) in patients with sclerosing cholangitis. Methods. All patients with sclerosing cholangitis who underwent SOC procedures due to suspicious biliary strictures, in one Swedish and four UK tertiary centers in 2008-2012, were retrospectively enrolled. For each SOC procedure in sclerosing cholangitis, another one attempted due to a single biliary stricture in the same center and calendar year was randomly selected as control. Patients were followed up until death or last clinic visit until November 2012. Results. Fifty-four SOC procedures were attempted in 52 sclerosing cholangitis patients (48 with primary sclerosing cholangitis, 4 with IgG4-related sclerosing cholangitis). Cannulation with the SOC system failed more frequently in sclerosing cholangitis (15% vs. 2% in controls; p = 0.015). The sensitivity, specificity, and accuracy of SOC (including tissue sampling) for cancer diagnosis were similar in sclerosing cholangitis and controls (50% vs. 55%, 100% vs. 97%, and 88% vs. 80%, respectively) with largely overlapping confidence intervals. Adverse events were more common in sclerosing cholangitis, due to an increased frequency of cholangitis (11% vs. 2% in controls; p = 0.051). Conclusions. SOC is equally accurate in cancer diagnosis in sclerosing cholangitis and patients with single biliary strictures. However, cholangioscope insertion may be hampered by bile duct narrowing and post-SOC cholangitis is more common in sclerosing cholangitis.},
  author       = {Kalaitzakis, Evangelos and Sturgess, Richard and Kaltsidis, Harry and Oppong, Kofi and Lekharaju, Venkata and Bergenzaun, Per and Vlavianos, Panagiotis and Sharma, Hemant and Westaby, David and Webster, George J},
  issn         = {1502-7708},
  language     = {eng},
  number       = {10},
  pages        = {1237--1244},
  publisher    = {Taylor & Francis},
  series       = {Scandinavian Journal of Gastroenterology},
  title        = {Diagnostic utility of single-user peroral cholangioscopy in sclerosing cholangitis.},
  url          = {http://dx.doi.org/10.3109/00365521.2014.936032},
  volume       = {49},
  year         = {2014},
}