The current diagnostic accuracy and inter-observer agreement of visual impression with digital single-operator cholangioscopy for the diagnosis of indeterminate biliary strictures

Aims Digital single-operator cholangioscopy (d-SOC) with cholangioscopic biopsy has shown promise in the evaluation of indeterminate biliary strictures (IBS). Some studies have suggested higher sensitivity for visual impression versus biopsies, however assessors were not blinded to previous investigations. We aimed to investigate the diagnostic accuracy and inter-observer agreement (IOA) of d-SOC in the visual appraisal of biliary strictures when blinded to history and previous results.