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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.

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기사명 저자명 페이지 원문 목차
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Can computed tomography colonography replace optical colonoscopy in detecting colorectal lesions? : state of the art Alessia Chini, Michele Manigrasso, Grazia Cantore, Rosa Maione, Marco Milone, Francesco Maione, Giovanni Domenico De Palma p. 183-190

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(Commentary) A novel aerosol-exposure protection mask for patients during upper endoscopy Soo-Jeong Cho p. 208-209

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(Commentary) Predicting malignancy by peroral pancreatoscopy of an intraductal papillary mucinous neoplasm with a dilated main pancreatic duct : is seeing enough? Yun Nah Lee, Jong Ho Moon p. 213-214

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Value of fecal calprotectin measurement during the initial period of therapeutic anti-tubercular trial Hyeong Ho Jo, Eun Young Kim, Jin Tae Jung, Joong Goo Kwon, Eun Soo Kim, Hyun Seok Lee, Yoo Jin Lee, Kyeong Ok Kim, Byung Ik Jang p. 256-262

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Endoscopic ultrasonography findings for Brunner's gland hamartoma in the duodenum Kyong Joo Lee, Bonil Park, Hee Man Kim p. 305-309

Large jejunal phytobezoar with small bowel obstruction treated by single-balloon enteroscopy Eun Young Park, Dong Hoon Baek, Bong Eun Lee, Gwang Ha Kim, Geun Am Song p. 310-312

(A) rare cause of subepithelial tumor in the gastric fundus Da Mi Kim, Gwang Ha Kim, Kyungbin Kim p. 313-314

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참고문헌 (53건) : 자료제공( 네이버학술정보 )

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번호 참고문헌 국회도서관 소장유무
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25 Wallace M, Lauwers GY, Chen Y, et al. Miami classification for probebased confocal laser endomicroscopy. Endoscopy 2011;43:882-891. 미소장
26 Caillol F, Filoche B, Gaidhane M, Kahaleh M. Refined probe-based confocal laser endomicroscopy classification for biliary strictures: the Paris Classification. Dig Dis Sci 2013;58:1784-1789. 미소장
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28 ASGE Standards of Practice Committee, Chathadi KV, Chandrasekhara V, et al. The role of ERCP in benign diseases of the biliary tract. Gastrointest Endosc 2015;81:795-803. 미소장
29 Tringali A, Lemmers A, Meves V, et al. Intraductal biliopancreatic imaging:european society of gastrointestinal endoscopy (ESGE) technology review. Endoscopy 2015;47:739-753. 미소장
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31 Caillol F, Bories E, Autret A, et al. Evaluation of pCLE in the bile duct:final results of EMID study : pCLE: impact in the management of bile duct strictures. Surg Endosc 2015;29:2661-2668. 미소장
32 Slivka A, Gan I, Jamidar P, et al. Validation of the diagnostic accuracy of probe-based confocal laser endomicroscopy for the characterization of indeterminate biliary strictures: results of a prospective multicenter international study. Gastrointest Endosc 2015;81:282-290. 미소장
33 Dubow M, Tatman PD, Shah RJ. Individual probe based confocal laser endomicroscopy criteria in the analysis of indeterminate biliary strictures. Scand J Gastroenterol 2018;53:1358-1363. 미소장
34 Koda H, Hara K, Nozomi O, et al. High-resolution probe-based confocal laser endomicroscopy for diagnosing biliary diseases. Clin Endosc 2021;54:924-929. 미소장
35 Konda VJA, Meining A, Jamil LH, et al. A pilot study of in vivo identification of pancreatic cystic neoplasms with needle-based confocal laser endomicroscopy under endosonographic guidance. Endoscopy 2013;45:1006-1013. 미소장
36 Nakai Y, Iwashita T, Park DH, Samarasena JB, Lee JG, Chang KJ. Diagnosis of pancreatic cysts: EUS-guided, through-the-needle confocal laser-induced endomicroscopy and cystoscopy trial: DETECT study. Gastrointest Endosc 2015;81:1204-1214. 미소장
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38 Krishna SG, Hart PA, Malli A, et al. Endoscopic ultrasound-guided confocal laser endomicroscopy increases accuracy of differentiation of pancreatic cystic lesions. Clin Gastroenterol Hepatol 2020;18:432-440. e6. 미소장
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40 Krishna SG, Hart PA, DeWitt JM, et al. EUS-guided confocal laser endomicroscopy:prediction of dysplasia in intraductal papillary mucinous neoplasms (with video). Gastrointest Endosc 2020;91:551-563.e5. 미소장
41 Hao S, Ding W, Jin Y, et al. Appraisal of EUS-guided needle-based confocal laser endomicroscopy in the diagnosis of pancreatic lesions: a single Chinese center experience. Endosc Ultrasound 2020;9:180-186. 미소장
42 Chin YK, Wu CCH, Tan DMY. The role of needle-based confocal laser endomicroscopy in the evaluation of pancreatic cystic lesions: a systematic review. Clin Endosc 2021;54:38-47. 미소장
43 Giovannini M, Caillol F, Monges G, et al. Endoscopic ultrasound-guided needle-based confocal laser endomicroscopy in solid pancreatic masses. Endoscopy 2016;48:892-898. 미소장
44 Orr J, Lockwood R, Roberts J, Shi C, Yachimski P. EUS and confocal endomicroscopic diagnosis of pancreatic acinar cell cystadenoma. Gastrointest Endosc 2018;88:769-770. 미소장
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49 Yang D, Samarasena JB, Jamil LH, et al. Endoscopic ultrasound-guided through-the-needle microforceps biopsy in the evaluation of pancreatic cystic lesions: a multicenter study. Endosc Int Open 2018;6:E1423-E1430. 미소장
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52 Aubreville M, Stoeve M, Oetter N, et al. Deep learning-based detection of motion artifacts in probe-based confocal laser endomicroscopy images. Int J Comput Assist Radiol Surg 2019;14:31-42. 미소장
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