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Related Concept Videos

Endoscopic Procedures III: Video Capsule Endoscopy01:28

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Bronchoscopy
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An Esophagogastroduodenoscopy (EGD) is a diagnostic procedure in which an endoscopist uses a flexible, lighted endoscope to visualize the upper gastrointestinal (GI) tract. The procedure includes visualizing the oropharynx, esophagus, stomach, and the first part of the small intestine, the duodenum.
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Endoscopic Procedures V: ERCP01:26

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Updated: Oct 21, 2025

Laparoscopic Common Bile Duct Exploration in Patients with a Previous History of Biliary Tract Surgery
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Digital single-operator cholangioscopy interobserver study using a new classification: the Mendoza Classification

Michel Kahaleh1, Monica Gaidhane1, Haroon M Shahid1

  • 1Department of Gastroenterology, Robert Wood Johnson University Hospital, New Brunswick, New Jersey, USA.

Gastrointestinal Endoscopy
|September 3, 2021
PubMed
Summary
This summary is machine-generated.

Digital single-operator cholangioscopy (DSOC) interpretation for biliary strictures shows improved agreement and accuracy with new criteria. This advancement aids in diagnosing neoplastic versus non-neoplastic conditions.

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Area of Science:

  • Gastroenterology
  • Endoscopy
  • Biliary Tract Diseases

Background:

  • Digital single-operator cholangioscopy (DSOC) is used for biliary tree visualization in stricture evaluation.
  • Interobserver agreement (IOA) for DSOC interpretation of indeterminate biliary strictures needs assessment.

Purpose of the Study:

  • To assess the interobserver agreement (IOA) of DSOC interpretation for indeterminate biliary strictures.
  • To evaluate the diagnostic accuracy of newly refined criteria for DSOC interpretation.

Main Methods:

  • Fourteen endoscopists reviewed a reference atlas of 5 DSOC criteria.
  • Fifty DSOC video clips were scored based on specific visual findings (vessels, nodulations, lesions, surface, friability).
  • Interclass correlation (ICC) analysis assessed agreement for criteria and neoplastic/non-neoplastic diagnoses.

Main Results:

  • Three of five revised criteria showed almost perfect agreement (ICC > .80).
  • Diagnostic ICC was almost perfect for both neoplastic (.90) and non-neoplastic (.90) diagnoses.
  • Overall diagnostic accuracy was 77% using the revised criteria.

Conclusions:

  • The new Mendoza criteria for DSOC interpretation significantly increased IOA and accuracy by 16% and 20% respectively.
  • A reference atlas aids formal training and may enhance diagnostic accuracy in DSOC.
  • DSOC with refined criteria offers improved diagnostic performance for indeterminate biliary strictures.