Appraisal of needle-based confocal laser endomicroscopy in the diagnosis of pancreatic cysts

Table 2 Developing role of endoscopic ultrasound guided needle based confocal laser endomicroscopy in diagnosis of pancreatic cystic lesions: Review of recently presented abstracts at international gastroenterology conferences (Digestive Disease Week and American College of Gastroenterology scientific meeting)

	Study objectives	Patient, n	Pancreatitis and other complications	Accuracy data	Conclusions
Napoleon et al[23]	To evaluate feasibility and assess complication rate of nCLE in CPLs	Total: 141	Minor pancreatitis: 2 (1.45%)	NA	Main technical limitation observed when cyst interrogation requires approach through second part of the duodenum
CONTACT study		Technical feasibility: 93% (131 patients)
DDW 2015			Intracystic bleeding without extravasation - 10%
	Prospective study
Kadayifci et al[28]	To assess the safety, feasibility and diagnostic value of EUS guided nCLE for CPLs	Total: 11	No pancreatitis reported	The sensitivity, specificity, and accuracy for mucinous cyst (findings of papillae) were 57%, 100%, and 70% respectively	nCLE for pancreatic cysts was safe and feasible. nCLE has low sensitivity but high specificity for mucinous cysts
DDW 2015		Procedure successful: 10
	Retrospective
Bertani et al[26] DDW 2015	To validate prior described nCLE findings typical of IPMN lesions	Total: 9	No pancreatitis reported	Finger-like projections were observed in 7 of 7 IPMN lesions	nCLE imaging identified common criteria for diagnosis of IPMN
	Retrospective
Krishna et al[25]	To validate prior described diagnostic nCLE imaging patterns	Total: 32	Pancreatitis: 3.1% (1 patient)	Sensitivity, specificity, and accuracy for IPMN were 89%, 100%, and 96% respectively	Promising technology providing diagnosis of mucinous cysts
DDW 2015		Inclusion: 26
		Surgery: 7 (27%)
	Retrospective
				Sensitivity, specificity, and accuracy for SCA were 90%, 100%, and 96% respectively
Sejpal et al[27]	To validate prior described nCLE findings for diagnosis of pancreatic cysts	Total: 19	No pancreatitis reported	Sensitivity, specificity, and accuracy for IPMN were 80%, 100%, and 95% respectively	Possibly treating pseudocysts after nCLE examination bypass fluid analysis
DDW 2015
	Retrospective
Joshi et al[36]	To validate available nCLE criteria for diagnosis of CPLs	Total: 16	No pancreatitis reported	Improved confidence in diagnosing type of cyst in 80% of patients	Can impact in management and avoiding unnecessary surgeries for pancreatic cysts
ACG 2014
Napoleon et al[37]	To investigate and describe nCLE characteristics of CPLs	Total: 31	No pancreatitis reported	NA	nCLE images could help in the differentiation of IPMNs, MCN and SCA
CONTACT study		Inclusion: 16
DDW 2014
	Prospective

DDW: Digestive Disease Week; ACG: American College of Gastroenterology; CPL: Cystic pancreatic lesions; NA: Not available; IPMN: Intraductal papillary mucinous neoplasm; MCN: Mucinous cystic neoplasm; SCA: Serous cystadenoma.