Effect of probe-based confocal laser endomicroscopy in the diagnosis of eight cases of indeterminate biliary strictures

Abstract

Objective To evaluate the diagnostic value of probe-based confocal laser endomicroscopy (pCLE) in indeterminate biliary strictures. Methods From March to September 2015, 10 patients with indeterminate biliary strictures underwent endoscopic retrograde cholangio-pancreatography (ERCP) were enrolled. The results of pCLE examination and brush cytology or post-operative pathological results were collected. Taking the final diagnosis as the gold standard, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), accuracy and 95% confidence interval (CI) of pCLE in the diagnosis of malignant biliary strictures were analyzed. Results Among the eight patients, seven cases were diagnosed as malignant biliary strictures. The sensitivity of pCLE in the diagnosis of malignant biliary strictures was 85.7%(95%CI 42.1% to 99.6%), the specificity was 100.0%(95%CI 2.5% to 100.0%), the PPV was 100.0%(95%CI 54.1% to 100.0%), the NPV was 50.0%(95%CI 1.3% to 98.7%) and the accuracy was 87.5%(95%CI 47.3% to 99.7%). Conclusion pCLE shows a high sensitivity and NPV in the diagnosis of indeterminate biliary strictures, which can improve the accuracy of the diagnosis of malignant biliary strictures. Key words: Confocal laser endomicroscopy; Probe; Biliary strictures; Diagnosis