Endoscopy 2018; 50(04): S82
DOI: 10.1055/s-0038-1637270
ESGE Days 2018 oral presentations
21.04.2018 – ERCP 4: Advanced procedures (cholangioscopy, pancreas)
Georg Thieme Verlag KG Stuttgart · New York

DIGITAL CHOLANGIOPANCREATOSCOPY: THE DIAGNOSTIC YIELD AND IMPACT ON MANAGEMENT OF PATIENTS WITH INDETERMINATE BILIARY AND PANCREATIC LESIONS

O Urban
1   Vitkovice Hospital, Gastroenterology, Ostrava, Czech Republic
2   Medical School, University of Ostrava, Ostrava, Czech Republic
,
E Skanderova
1   Vitkovice Hospital, Gastroenterology, Ostrava, Czech Republic
,
P Fojtik
1   Vitkovice Hospital, Gastroenterology, Ostrava, Czech Republic
,
V Zoundjiekpon
1   Vitkovice Hospital, Gastroenterology, Ostrava, Czech Republic
,
M Loveček
3   Palacky University in Olomouc, Surgical Clinic, Olomouc, Czech Republic
,
P Falt
1   Vitkovice Hospital, Gastroenterology, Ostrava, Czech Republic
2   Medical School, University of Ostrava, Ostrava, Czech Republic
› Author Affiliations
Further Information

Publication History

Publication Date:
27 March 2018 (online)

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Aims:

Single operator cholangiopancreatoscopy (SOC) is an adjunct to endoscopic retrograde cholangiopancreatography used either for diagnostics of ductal lesions or navigated intraductal therapy. The purpose of this study is to evaluate operating characteristics and impact on management of patients with indeterminate biliary and pancreatic lesions.

Methods:

All patients undergoing SOC between January 2016 and June 2017 in a single center with experience with 50 SOCs were prospectively followed. SOC navigated biopsy was attempted in all visualized lesions.

Results:

Among 30 patients, 15 (50%) were males and 15 (50%) were females. Mean age was 67 ± 10,7 years. The visualization of the lesion was achieved in 30 (100%) of cases. Lesions were located in extrahepatic duct 12 (40%), confluens 14 (47%), intrahepatic ducts 2 (7%) and pancreatic duct 2 (7%). The biopsy was performed in 27 (90%) and was representative in 26 (87%). The final diagnosis was malignant in 11 (37%) and benign in 19 (63%) of cases. Operating characteristics of endoscopy features to diagnose malignant lesion were; % (95% CI %): sensitivity 100 (72 – 100), specificity 79 (5 – 94), positive predictive value (PPV) 73 (54 – 87) and negative predictive value (NPV) 100. Operating characteristics for biopsy were; (95% CI %): sensitivity 90 (56 – 100), specificity 100 (80 – 100), PPV 100, NPV 94 (73 – 99). The final treatment was surgical in 6 (20%), endoscopic in 14 (47%), chemoradiotherapy in 3 (10%) and palliative care in 7 (23%) of cases. The 30 day mortality was 2 (7%) due to cholangitis related to SOC and progression of malignancy.

Conclusions:

In our study, SOC with navigated biopsy demonstrated a high diagnostic accuracy in patients with indeterminate biliary and pancreatic lesions and it led to positive impact on treatment in 77% of patients. Nevertheless, SOC-related mortality due to cholangitis was 3%.