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01-09-2015

Evaluation of pCLE in the bile duct: final results of EMID study

pCLE: impact in the management of bile duct strictures

Authors: Fabrice Caillol, Erwan Bories, Aurelie Autret, Flora Poizat, Christian Pesenti, Jacques Ewald, Olivier Turrini, Jean Robert Delpero, Genevieve Monges, Marc Giovannini

Published in: Surgical Endoscopy | Issue 9/2015

Abstract

Introduction

Pre-operative histology of bile duct stenosis is associated with low accuracy. Probe confocal laser endomicroscopy (pCLE) enables optical biopsy or in vivo histology. The definitive results of the EMID study are presented here, comparing optical biopsies with definitive histology.

Aims and methods

Sixty one patients with a biliary stricture without any previous histology were included (July 2007–May 2012). An endoscopic ultrasound (EUS) had to be conducted before the ERCP procedure. pCLE was done using CholangioFlex during the ERCP procedure. Results were compared to those of definitive histology obtained by biopsy or surgery in case of malignant lesions, and by surgery or 1-year follow-up in case of benign lesions.

Results

Six patients were excluded because no definitive histology was available. There were 41 malignant lesions and 14 benign lesions. Sensitivity, specificity, PPV, NPV, and accuracy with combination of pCLE with endobiliary and EUS biopsies were 100, 71, 91, 100, and 93 %, respectively (with a significant increase of accuracy compared with endobiliary and EUS biopsies without pCLE, p = 0.03). 19 patients had a biliary stricture without individualized mass (6 malignant lesions, 13 benign lesions). Sensitivity, specificity, PPV, NPV, and accuracy for pCLE were 83, 77, 62, 91, and 79 %, respectively. Sensitivity, specificity, PPV, NPV, and accuracy for combination of pCLE with endobiliary and EUS biopsies were 100, 69, 60, 100, and 79 %, respectively.

Conclusion

The addition of a pCLE procedure in the diagnostic histologic examination of a biliary stricture permits a significant increase in diagnostic reliability and allows for a VPN of 100 %.

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Title: Evaluation of pCLE in the bile duct: final results of EMID study
pCLE: impact in the management of bile duct strictures
Authors: Fabrice Caillol
Erwan Bories
Aurelie Autret
Flora Poizat
Christian Pesenti
Jacques Ewald
Olivier Turrini
Jean Robert Delpero
Genevieve Monges
Marc Giovannini
Publication date: 01-09-2015
Publisher: Springer US
Published in: Surgical Endoscopy / Issue 9/2015
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-014-3986-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Evaluation of pCLE in the bile duct: final results of EMID study

pCLE: impact in the management of bile duct strictures

Abstract

Introduction

Aims and methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Aims and methods

Results

Conclusion

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