BACKGROUND: The diagnostic accuracy of cholangioscopy-guided sampling has not been rigorously evaluated. OBJECTIVE: To prospectively evaluate the accuracy of cholangioscopy-guided mini-forceps sampling and compare it with standard cytology brushings and forceps biopsies for the tissue diagnosis of indeterminate @entity253 . DESIGN: Prospective, long-term follow-up, paired design cohort study. SETTING: Tertiary center. @entity1 : @entity1 undergoing cholangioscopy for the evaluation of indeterminate @entity253 . INTERVENTIONS: Each @entity1 underwent triple sampling with cholangioscopy-guided mini-forceps, cytology brushing, and standard forceps. MAIN OUTCOME MEASUREMENTS: Diagnostic accuracy of each sampling method compared with the @entity1 final status ( @entity5 vs no @entity5 ). RESULTS: A total of 26 @entity1 (17 @entity5 positive/9 @entity5 negative) were enrolled. The mean follow-up in the @entity1 with no @entity5 was 21.78 (SD   6.78) months. The procedure was technically successful in all cases (100%). Sample quality was adequate in 25 of 26 (96.2%) of the cytology brushings, in 26 of 26 (100%) of the standard forceps biopsies, and in 25 of 26 (96.2%) of the mini-forceps biopsies. The sensitivity, accuracy, and negative predictive values were 5.9%, 38.5%, and 36% for standard cytology brushings; 29.4%, 53.8%, and 42.8% for standard forceps biopsies; and 76.5%, 84.6%, and 69.2% for mini-forceps biopsies, respectively. When comparing the 3 methods of sampling, mini-forceps biopsy provided significantly better sensitivity and overall accuracy compared with standard cytology brushing (P < .0001) and standard forceps biopsy (P = .0215). LIMITATIONS: Potential for selection bias. CONCLUSIONS: Cholangioscopy-guided biopsies of indeterminate @entity253 have significantly higher accuracy compared with ERCP-guided cytology brushings and standard forceps biopsies, but negative findings on mini-forceps biopsy cannot rule out malignancy with a high degree of certainty. ( CLINICAL TRIAL REGISTRATION NUMBER: NCT01227382.).

Diagnostic accuracy of conventional and cholangioscopy-guided sampling of indeterminate XXXX at the time of ERCP: a prospective, long-term follow-up study.

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients', 'patient', 'PATIENTS'] @entity253 :: ('MESH:D001660', 'Disease') :: ['biliary lesions'] @entity5 :: ('MESH:D009369', 'Disease') :: ['cancer']
@entity253 :: (MESH:D001660,Disease) :: ['biliary lesions']
