Single-operator cholangioscopy is useful for visual assessment of bile duct pathology
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Single-operator cholangioscopy is useful for visual assessment of bile duct pathology. / Mellemgaard, Finnur; Strandby, Rune B; Blockmann, Julie; Kofoed, Steen C; Svendsen, Lars B; Achiam, Michael P.
I: Danish Medical Journal, Bind 65, Nr. 8, A5496, 2018.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Single-operator cholangioscopy is useful for visual assessment of bile duct pathology
AU - Mellemgaard, Finnur
AU - Strandby, Rune B
AU - Blockmann, Julie
AU - Kofoed, Steen C
AU - Svendsen, Lars B
AU - Achiam, Michael P
N1 - Articles published in the DMJ are “open access”. This means that the articles are distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits any non-commercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.
PY - 2018
Y1 - 2018
N2 - INTRODUCTION: Single-operator cholangioscopy (SOC) is increasingly used for evaluation of the biliary tree following endoscopic retrograde cholangiopancreaticography (ERCP). This study aimed to determine the visual and histological success rates of SOC at a single Danish tertiary referral centre.METHODS: All patients undergoing SOC between 2008 and 2015 were retrospectively included from a prospectively maintained database. Patient characteristics and proced-ure-related variables were obtained from medical records. A visual and a histological success rate were determined according to predefined criteria.RESULTS: In total, 54 patients underwent SOC, most often due to suspicion of malignancy (n = 53; 98%). In one case, access to the common bile duct failed, and in six cases malignant disease was missed. Thus, the cholangioscopies were successful in 47 of 54 procedures corresponding to a visual success rate of 87%. Nine patients (17%) had a mean of 1.3 ± 1.0 SOC-guided biopsies taken. The extracted tissue was inadequate for histological evaluation in seven of nine cases, corres-pond-ing to a histological success rate of 22% (two out of nine tissue samples were eligible for histological diagnosis).CONCLUSIONS: Considering the reasonable visual success rate, SOC seems to be a useful extension of ERCP during diagnostic work-up for detection of malignant disease in the biliary tree. However, one biopsy per patient is insufficient for histological verification of common bile duct malignancy.TRIAL REGISTRATION: The Danish Health Authority (3-3013-1299/1) and The Danish Data Protection Agency (RH-2015-229).FUNDING: none.
AB - INTRODUCTION: Single-operator cholangioscopy (SOC) is increasingly used for evaluation of the biliary tree following endoscopic retrograde cholangiopancreaticography (ERCP). This study aimed to determine the visual and histological success rates of SOC at a single Danish tertiary referral centre.METHODS: All patients undergoing SOC between 2008 and 2015 were retrospectively included from a prospectively maintained database. Patient characteristics and proced-ure-related variables were obtained from medical records. A visual and a histological success rate were determined according to predefined criteria.RESULTS: In total, 54 patients underwent SOC, most often due to suspicion of malignancy (n = 53; 98%). In one case, access to the common bile duct failed, and in six cases malignant disease was missed. Thus, the cholangioscopies were successful in 47 of 54 procedures corresponding to a visual success rate of 87%. Nine patients (17%) had a mean of 1.3 ± 1.0 SOC-guided biopsies taken. The extracted tissue was inadequate for histological evaluation in seven of nine cases, corres-pond-ing to a histological success rate of 22% (two out of nine tissue samples were eligible for histological diagnosis).CONCLUSIONS: Considering the reasonable visual success rate, SOC seems to be a useful extension of ERCP during diagnostic work-up for detection of malignant disease in the biliary tree. However, one biopsy per patient is insufficient for histological verification of common bile duct malignancy.TRIAL REGISTRATION: The Danish Health Authority (3-3013-1299/1) and The Danish Data Protection Agency (RH-2015-229).FUNDING: none.
KW - Aged
KW - Bile Ducts/pathology
KW - Biliary Tract Diseases/diagnostic imaging
KW - Biopsy
KW - Cholangiopancreatography, Endoscopic Retrograde
KW - Denmark
KW - Endoscopy, Digestive System/methods
KW - Female
KW - Humans
KW - Male
KW - Middle Aged
KW - Retrospective Studies
KW - Tertiary Care Centers
M3 - Journal article
C2 - 30059003
VL - 65
JO - Danish Medical Journal
JF - Danish Medical Journal
SN - 2245-1919
IS - 8
M1 - A5496
ER -
ID: 217564952