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A feasibility study of digital single-operator cholangioscopy for diagnostic and therapeutic procedure (with videos).

Abstract：

:Recently, the novel SpyGlass DS Direct Visualization system (SPY DS) has become available. This system offers several advantages over the conventional SPYGlass system. This study evaluated the clinical feasibility and efficacy of diagnostic and therapeutic procedures for biliary disorder using SPY DS.In this retrospective study, consecutive patients who had biliary disorder were enrolled between November 2015 and February 2016. All patients could not be diagnosed or treated by standard endoscopic retrograde cholangiopancreatography in our hospital or at another hospital.A total of 28 consecutive patients (21 men and 7 women; median age, 73 years; age range, 55-87 years) were retrospectively enrolled in this study. Among them, diagnostic procedure was performed in 20 patients, and 8 patients underwent therapeutic procedures. The technical success rate for diagnostic procedures was 100% (20/20). Diagnostic accuracy was 100% (19/19). The technical success rate for therapeutic procedures was 88% (7/8). Among these 8 patients, 4 patients with common bile duct stones underwent electrohydraulic lithotripsy. One patient successfully underwent guidewire insertion to remove a migrated plastic stent. The 3 remaining patients underwent SPY DS to insert a guidewire for left bile duct obstruction and for posterior bile duct branch. In the patient who underwent guidewire insertion for left hepatic bile duct obstruction cause by primary sclerosing cholangitis, we could not advance the guidewire into the left hepatic bile duct. No adverse events were seen. Median SPY DS insertion time was 21 min (range, 8-32 min).Single-operator cholangioscopy using SPY DS was feasible and had a marked clinical impact in patients with biliary disease. Additional case reports and prospective studies are needed to examine further applications of this system.

journal_name

Medicine (Baltimore)

journal_title

Medicine

authors

Imanishi M,Ogura T,Kurisu Y,Onda S,Takagi W,Okuda A,Miyano A,Amano M,Nishioka N,Masuda D,Higuchi K

doi

10.1097/MD.0000000000006619

subject

Has Abstract

pub_date

2017-04-01 00:00:00

pages

e6619

issue

eissn

0025-7974

issn

1536-5964

pii

00005792-201704140-00043

journal_volume

pub_type

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A feasibility study of digital single-operator cholangioscopy for diagnostic and therapeutic procedure (with videos).