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Diagnostic utility of single-user peroral cholangioscopy in sclerosing cholangitis

Lookup NU author(s): Professor Kofi Oppong

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Abstract

© 2014 Informa Healthcare. 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.

Publication metadata

Author(s): Kalaitzakis E, Sturgess R, Kaltsidis H, Oppong K, Lekharaju V, Bergenzaun P, Vlavianos P, Sharma H, Westaby D, Webster GJ

Publication type: Article

Publication status: Published

Journal: Scandinavian Journal of Gastroenterology

Year: 2014

Volume: 49

Issue: 10

Pages: 1237-1244

Online publication date: 10/07/2014

Acceptance date: 11/06/2014

ISSN (print): 0036-5521

ISSN (electronic): 1502-7708

Publisher: Informa Healthcare

URL: https://doi.org/10.3109/00365521.2014.936032

DOI: 10.3109/00365521.2014.936032

PubMed id: 25007715

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