SynthesisSurgical endoscopy2022
Diagnostic performance of digital and video cholangioscopes in patients with suspected malignant biliary strictures: a systematic review and meta-analysis.
Synthesis in Surgical endoscopy, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
18 citing papers in PubMed, 1 synthesis or guideline pooled it, 28 citations in OpenAlex.
- Chinese national clinical practice guideline on diagnosis and treatment of biliary tract cancers.Chinese medical journal · 2024Guideline
- A novel sheath system to improve target access for preoperative mapping biopsy: A randomized trial to inform surgical planning.Surgical endoscopy · 2026Trial
- Feasibility of Novel Slim Peroral Cholangiopancreatoscopy for the Diagnosis of Pancreatobiliary Disease.DEN open · 2026Article
- Advances in Diagnosis and Treatment With Cholangiopancreatoscopy.Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society · 2026Review
- Initial Results from a Novel Video Cholangiopancreatoscope: An International Multicenter Study.Endoscopy international open · 2026Article
- Endoscopic approach to indeterminate biliary strictures.Clinical endoscopy · 2026Review
- A modified tetra-bite-on-bite biopsy technique under cholangioscopic guidance for biliary disease.Endoscopy · 2025Article
- Peroral cholangioscopy: past, present and future.Clinical endoscopy · 2025Review
- Diagnostic cholangioscopy for surgical planning of extrahepatic cholangiocarcinoma.Scientific reports · 2025Article
- Endoscopic treatment of unresectable perihilar cholangiocarcinoma: beyond biliary drainage.Therapeutic advances in gastroenterology · 2025Review
- The updated Asia-Pacific consensus statement on the role of endoscopic management in malignant hilar biliary obstruction.Endoscopy international open · 2024Article
- Endoscopic evaluation of indeterminate biliary strictures: Cholangioscopy, endoscopic ultrasound, or both?Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society · 2024Review
- Atlas for Cholangioscopy and Cholecystoscopy: A Primer for Diagnostic and Therapeutic Endoscopy in the Biliary Tree and Gallbladder.Seminars in interventional radiology · 2024Review
- A rare case of resection of a mucinous cystic neoplasm originating from the extrahepatic bile duct with cholangioscopic imaging.DEN open · 2024Article
- Accurate and safe diagnosis and treatment of neoplastic biliary lesions using a novel 9F and 11F digital single-operator cholangioscope.Endoscopy international open · 2024Article
- A missed case of intraductal oncocytic papillary neoplasm associated with missed stones in extrahepatic bile duct: a case report.Frontiers in oncology · 2024Article
- Review
- Peroral cholangioscopy: Update on the state-of-the-art.World journal of gastrointestinal endoscopy · 2022Article
Corrections and comments
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPer-oral cholangioscopy (POC) has evolved over the past decade from fiberoptic to digital and video imaging systems. Nowadays, only direct per-oral cholangioscopy (DPOC) and digital single-operator cholangioscopy (DS) are performed in daily practice. With better image resolution, POC is increasingly used as diagnostic tools in patients with suspected malignant biliary stricture (MBS). We aimed to evaluate the diagnostic yield of digital/video cholangioscopes for the diagnosis of MBS.
methodsA systematic search was performed in MEDLINE, Embase, and ISI Web of Knowledge databases until April 2020, to identify randomized controlled trials and prospective studies using digital or video POC. The meta-analysis of diagnostic accuracy study was performed to calculate summary estimates of the primary outcomes, including pooled sensitivity, and specificity of POC to diagnose MBS using bivariate random-effects models. Tissue histopathology was used as the reference standard for MBS diagnosis. For benign stricture, negative tissue histopathology and at least 6 months clinical follow-up were required.
resultsThirteen original articles with 876 patients were identified. The overall pooled sensitivity and specificity were 88 (95% CI 83-91) and 95 (95% CI 89-98), respectively. The area under the curve (AUROC) was 0.94 (95% CI 0.92-0.96). Subgroup analysis showed that cholangioscopic image impression provided significantly higher sensitivity (93% (95% CI 88-96) vs 82% (95% CI 76-87); p = 0.007), but lower specificity 86% (95% CI 75-92) vs 98 (95% CI 95-99); p < 0.001) than the tissue diagnosis from cholangioscopic-guided biopsy. In addition, biopsy obtained from DPOC had significantly higher sensitivity than that of DS (92% (95% CI 81-97) vs 79% (95% CI 72-84); p = 0.004). Diagnostic performance under image-enhanced endoscopy was not significantly better from white light endoscopy.
conclusionsDigital/video POC has very high diagnostic performance to diagnose MBS. While image diagnosis provides higher sensitivity than biopsy, its specificity drops as a trade-off.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.