Comparative Diagnostic Accuracy of Cholangioscopy-Based Modalities for Indeterminate Biliary Strictures: A Systematic Review and Network Meta-Analysis.
Dig Dis SciJul 11, 2026 (epub)
Abdul Subhan Talpur, Kainat Urooj, Fawad Talat et al.
✦ AI-curated · Sources linked
In 30 seconds
This systematic review and network meta-analysis evaluated the diagnostic accuracy of five modalities for indeterminate biliary strictures in 4,912 patients. Single-operator cholangioscopy (SOC) with SpyGlass DS showed the highest pooled sensitivity for malignancy at 82%, while brush cytology had the lowest sensitivity at 45%. The study highlights the comparative performance of these diagnostic strategies.
Key findings
- SOC achieved the highest pooled sensitivity at 82% (95% CrI: 76%-88%) for malignancy.
- Brush cytology had the lowest sensitivity at 45% (95% CrI: 38%-52%).
- SOC was associated with a higher adverse-event rate than cytology-based sampling (6.8% vs. 2.1%).
- Brush cytology had the highest specificity at 97% (95% CrI: 94%-99%).
Why it matters
Understanding the comparative diagnostic accuracy of these modalities is crucial for clinicians managing indeterminate biliary strictures, as it informs decision-making regarding the most effective and safest diagnostic approach.