Digital cholangioscopy: the diagnostic yield and impact on management of patients with biliary stricture

Abstract:Objectives: Biliary strictures frequently present a diagnostic challenge. The aim of this study was to evaluate the impact of digital single-operator cholangioscopy (DSOC) on subsequent treatment of patients with biliary stricture.Methods: Consecutive patients undergoing DSOC for biliary stricture were enrolled. Gold standard for final diagnosis included histology from surgical resection. In patients without surgery, clinical evaluation methods and repeated imaging studies were used for comparison of DSOC findings and final diagnosis. Patients were followed-up prospectively focusing on subsequent treatment.Results: Among 30 enrolled patients, final diagnosis was malignant in 13 (43%) and benign in 17 (57%). The sensitivity and specificity of visual impression in diagnosing malignant stricture were 100% (95% CI: 75 − 100) and 76% (95% CI: 50 − 93), respectively. The sensitivity and specificity for biopsy were 92% (95% CI: 62 − 100) and 100% (95% CI: 78 − 100), respectively. One (3%) case of compli...