Diagnostic and therapeutic single-operator cholangiopancreatoscopy in biliopancreatic diseases: Prospective multicenter study in Japan

Table 1 Overall characteristics of 148 patients who underwent single-operator cholangiopancreatoscopy

Characteristic	Value
Male/female, n	98/50
Mean age (yr), (range)	68.4 (38-93)
Previous examination, n (%)
CT	146 (98.6)
MRCP	96 (64.9)
ERCP	148 (100)
Preparation of the papilla, n (%)
EST	130 (87.8)
EPBD	3 (2.1)

CT: Computed tomography; MRCP: Magnetic resonance cholangiopancreatography; ERCP: Endoscopic retrograde cholangiopancreatography; EST: Endoscopic sphincterotomy; EPBD: Endoscopic papillary balloon dilation.

Table 2 Characteristic of 89 patients with indeterminate bile duct lesions

Bile duct target site	n
Intrahepatic	10
Hilar	26
Superior	19
Mid	17
Inferior	15
Mobile filling defect	2
Suspected disease
Bile duct cancer	58
Cystic duct cancer	2
IPNB	2
IgG4-related cholangitis	3
PSC	3
Inflammatory change	19
Bile duct stone	2

IPNB: Intraductal papillary neoplasm in the bile duct; PSC: Primary sclerosing cholangitis.

Table 3 Accuracy of single-operator cholangiopancreatoscopy impression in indeterminate bile duct lesion, n

Diagnosis by SOCPS impression	Final diagnosis
	Malignant	Benign
Malignant	54	2
Benign	3	25

Sensitivity, 94.7%; Specificity, 92.6%; Accuracy, 94.0%. SOCPS: Single-operator cholangiopancreatoscopy.

Table 4 Procedure success rate of diagnostic single-operator cholangiopancreatoscopy for indeterminate bile duct lesions

Bile duct targetsite	n	Success rate of visualizing target site, n (%)	Biopsy attempted(n)	Adequate tissue forhistologic examination, n (%)
Intrahepatic	10	8 (80.0)	6	5 (83.3)
Hilar	26	26 (100)	26	21 (80.8)
Superior	19	19 (100)	19	15 (78.9)
Mid	17	16 (94.1)	14	12 (85.7)
Inferior	15	13 (86.7)	10	7 (70.0)
Mobile filing defect	2	2 (100)	0
Overall	89	84 (95.5)	75	60 (80.0)

Table 5 Accuracy of histologic diagnosis using single-operator cholangiopancreatoscopy-directed biopsies in indeterminate bile duct lesions (n = 75)

Diagnosis by SOCPS-biopsy	Final diagnosis (n)
	Malignant	Benign
Malignant	37	0
Benign	20	16
Inadequate	0	2

Sensitivity, 64.9%; Specificity, 88.9%; Accuracy, 70.7%. SOCPS: Single-operator cholangiopancreatoscopy.

Table 6 Characteristic of 17 patients who underwent single-operator cholangiopancreatoscopy with pancreatic duct lesion

Location of main lesion of pancreatic duct	n
Head of pancreas	14
Body	2
Tail	1
Suspected disease
Pancreatic cancer	1
IPMN	16
Preparation of the papilla
EST	1
EPBD	1

IPMN: Intraductal papillary mucinous neoplasm; EST: Endoscopic sphincterotomy; EPBD: Endoscopic papillary balloon dilation.

Table 7 Procedure success rate of diagnostic single-operator cholangiopancreatoscopy for pancreatic duct lesions n (%)

Pancreatic duct target site	n	Successrate of visualizing target site	Biopsy performed,n	Adequatetissue for histologic examination
Head	15	14 (93.3)	10	9 (90.0)
Body	1	0 (0)	0	0 (0.0)
Tail	1	1 (100.0)	1	1 (100)
Overall	17	15 (88.2)	11	10 (90.9)

Table 8 Characteristics of 38 patients with single-operator cholangiopancreatoscopy-guided stone therapy

Characteristic	Value
Male/female, n	23/15
Mean age (yr), (range)	65.8 (38-93)
Bile duct stones, n	31
Mean size of stone (mm), (range)	20.6 (5-48)
Cause of difficulty of conventional treatment, n
Confluence stone	14
Large impact stone > 20 mm	14
Intrahepatic stone	3
Pancreatic stone, n	7
Mean size of stone (mm), (range)	13.9 (7-30)
Cause of difficulty of conventional treatment, n
Impact stone	6
Large stone > 20 mm	1
Pretreatment of the papilla, n
EST	37
EPBD	1
Devices used during stone therapy
EHL	15
YAG laser	20

EST: Endoscopic sphincterotomy; EPBD: Endoscopic papillary balloon dilation; EHL: Electrohydraulic lithotripsy.