Abstract
Background/Aims: Endoscopic visualization of the microscopic anatomy can facilitate the real-time diagnosis of pancreatobiliary disorders and provide guidance for treatment. This study aimed to review the technique, image classification, and diagnostic performance of confocal laser endomicroscopy (CLE). Methods: We conducted a systematic review of CLE in pancreatic and biliary ducts of humans, and have provided a narrative of the technique, image classification, diagnostic performance, ongoing research, and limitations. Results: Probe-based CLE differentiates malignant from benign biliary strictures (sensitivity, ≥89%; specificity, ≥61%). Needle-based CLE differentiates mucinous from non-mucinous pancreatic cysts (sensitivity, 59%; specificity, ≥94%) and identifies dysplasia. Pancreatitis may develop in 2-7% of pancreatic cyst cases. Needle-based CLE has potential applications in adenocarcinoma, neuroendocrine tumors, and pancreatitis (chronic or autoimmune). Costs, catheter lifespan, endoscopist training, and interobserver variability are challenges for routine utilization. Conclusions: CLE reveals microscopic pancreatobiliary system anatomy with adequate specificity and sensitivity. Reducing costs and simplifying image interpretation will promote utilization by advanced endoscopists.
Original language | English (US) |
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Pages (from-to) | 197-207 |
Number of pages | 11 |
Journal | Clinical Endoscopy |
Volume | 55 |
Issue number | 2 |
DOIs | |
State | Published - Mar 2022 |
Keywords
- Biliary stricture
- Cholangiocarcinoma
- Confocal microscopy
- Endoscopy
- Pancreatic cyst
ASJC Scopus subject areas
- Medicine (miscellaneous)
- Radiology Nuclear Medicine and imaging
- Gastroenterology