Sa1465 SINGLE OPERATOR CHOLANGIOSCOPY- DIRECTED BIOPSIES IMPROVES DIAGNOSTIC YIELD FOR CHOLANGIOCARCINOMA AND IS SAFE IN PATIENTS WITH PRIMARY SCLEROSING CHOLANGITIS

Single operator cholangioscopy (SOC) has demonstrated to be a useful tool in the evaluation of indeterminate biliary strictures. However much of the incremental benefit has been ascribed to the visual interpretation of cholangioscopy and not due to histologic yield from SOC-directed biopsies. Furthermore, SOC has been suggested to be a cost-effective strategy for evaluation of indeterminate biliary strictures in patients with primary sclerosing cholangitis (PSC), but data comparing the addition of fluorescent in situ hybridization (FISH) to SOC in this population is lacking. The purpose of this study is to assess the performance characteristics of histopathology from SOC-directed biopsies compared to traditional sampling techniques [Routine brush cytology (Bc), fluorescent in situ hybridization (FISH), and transpapillary fluoroscopic-guided cold biopsy (Bx)] for indeterminate biliary strictures and to compare diagnostic yield and safety of the procedure in patients with and without PSC.