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01-08-2020 | Review Article

Efficacy of digital single-operator cholangioscopy in the visual interpretation of indeterminate biliary strictures: a systematic review and meta-analysis

Authors: Pedro Victor Aniz Gomes de Oliveira, Diogo Turiani Hourneaux de Moura, Igor Braga Ribeiro, Ahmad Najdat Bazarbashi, Tomazo Antonio Prince Franzini, Marcos Eduardo Lera dos Santos, Wanderley Marques Bernardo, Eduardo Guimarães Hourneaux de Moura

Published in: Surgical Endoscopy | Issue 8/2020

Abstract

Objective

Indeterminate biliary strictures remain a significant diagnostic challenge. Digital single-operator cholangioscopy (D-SOC) incorporates digital imaging which enables higher resolution for better visualization and diagnosis of biliary pathology. We aimed to conduct a systematic review and meta-analysis of available literature in an attempt to determine the efficacy of D-SOC in the visual interpretation of indeterminate biliary strictures.

Material and methods

Electronic searches were performed using Medline (PubMed), EMBASE, and Cochrane Library. All D-SOC studies that reported the diagnostic performance in visual interpretation of indeterminate biliary strictures and biliary malignancies were included. The Quality Assessment of Diagnostic Accuracy Studies (QUADAS)-2 was used to evaluate the quality of the included studies. All data were extracted and pooled to construct a 2 × 2 table. The visual interpretation of D-SOC was compared to resected surgical specimens or clinical follow-up in the included patients. Pooled sensitivity, specificity, positive predictive value, negative predictive value, prevalence, positive likelihood ratio (+LR), negative likelihood ratio (−LR), and diagnostic odds ratio (OR) were calculated. The summarized receiver operating characteristic (SROC) curve corresponding with the area under the curve (AUC) was also analyzed.

Results

The search yielded 465 citations. Of these, only six studies with a total of 283 procedures met inclusion criteria and were included in the meta-analysis. The overall pooled sensitivity and specificity of D-SOC in the visual interpretation of biliary malignancies was 94% (95% CI 89–97) and 95% (95%CI 90–98), respectively, while +LR, −LR, diagnostic OR, and AUC were 15.20 (95%CI 5.21–44.33), 0.08 (95%CI 0.04–0.14), 308.83 (95%CI 106.46–872.82), and 0.983, respectively. The heterogeneity among 6 included studies was moderate for specificity (I² = 0.51) and low for sensitivity (I² = 0.17) and diagnostic OR (I² = 0.00).

Conclusion

D-SOC is associated with high sensitivity and specificity in the visual interpretation of indeterminate biliary strictures and malignancies. D-SOC should be considered routinely in the diagnostic workup of indeterminate biliary lesions.

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Title: Efficacy of digital single-operator cholangioscopy in the visual interpretation of indeterminate biliary strictures: a systematic review and meta-analysis
Authors: Pedro Victor Aniz Gomes de Oliveira
Diogo Turiani Hourneaux de Moura
Igor Braga Ribeiro
Ahmad Najdat Bazarbashi
Tomazo Antonio Prince Franzini
Marcos Eduardo Lera dos Santos
Wanderley Marques Bernardo
Eduardo Guimarães Hourneaux de Moura
Publication date: 01-08-2020
Publisher: Springer US
Published in: Surgical Endoscopy / Issue 8/2020
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-020-07583-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Efficacy of digital single-operator cholangioscopy in the visual interpretation of indeterminate biliary strictures: a systematic review and meta-analysis

Abstract

Objective

Material and methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objective

Material and methods

Results

Conclusion

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