Accurate and safe diagnosis and treatment of neoplastic biliary lesions using a novel 9F and 11F digital single-operator cholangioscope.

Autor:	Robles-Medranda C; Gastroenterology, Instituto Ecuatoriano de Enfermedades Digestivas - IECED, Guayaquil, Ecuador., Alcivar-Vasquez J; Gastroenterology, Instituto Ecuatoriano de Enfermedades Digestivas - IECED, Guayaquil, Ecuador., Raijman I; Gastroenterology, Digestive Associates of Houston, Houston, United States., Kahaleh M; Gastroenterology, Robert Wood Johnson Medical School, New Brunswick, United States., Puga-Tejada M; Gastroenterology, Instituto Ecuatoriano de Enfermedades Digestivas - IECED, Guayaquil, Ecuador., Del Valle R; Gastroenterology, Instituto Ecuatoriano de Enfermedades Digestivas - IECED, Guayaquil, Ecuador., Alvarado H; Gastroenterology, Instituto Ecuatoriano de Enfermedades Digestivas - IECED, Guayaquil, Ecuador., Cifuentes-Gordillo C; Gastroenterology, Instituto Ecuatoriano de Enfermedades Digestivas - IECED, Guayaquil, Ecuador., Binmoeller KF; Gastroenterology, California Pacific Medical Center, San Francisco, United States., Baptista AJ; Endoscopy, Hospital de Clinicas Caracas, Caracas, Venezuela, Bolivarian Republic of., Barreto-Perez J; Gastroenterology, Instituto Ecuatoriano de Enfermedades Digestivas - IECED, Guayaquil, Ecuador., Rodriguez J; Gastroenterology, Instituto Ecuatoriano de Enfermedades Digestivas - IECED, Guayaquil, Ecuador., Egas-Izquierdo M; Gastroenterology, Instituto Ecuatoriano de Enfermedades Digestivas - IECED, Guayaquil, Ecuador., Cunto D; Gastroenterology, Instituto Ecuatoriano de Enfermedades Digestivas - IECED, Guayaquil, Ecuador., Calle-Loffredo D; Gastroenterology, Instituto Ecuatoriano de Enfermedades Digestivas - IECED, Guayaquil, Ecuador., Lukashok H; Gastroenterology, Instituto Ecuatoriano de Enfermedades Digestivas - IECED, Guayaquil, Ecuador., Baquerizo-Burgos J; Gastroenterology, Instituto Ecuatoriano de Enfermedades Digestivas - IECED, Guayaquil, Ecuador., Tabacelia D; Gastroenterology, Elias Emergency University Hospital, Bucuresti, Romania.; Gastroenterology, Carol Davila University of Medicine and Pharmacy, Bucuresti, Romania.
Jazyk:	angličtina
Zdroj:	Endoscopy international open [Endosc Int Open] 2024 Apr 05; Vol. 12 (4), pp. E498-E506. Date of Electronic Publication: 2024 Apr 05 (Print Publication: 2024).
DOI:	10.1055/a-2282-6678
Abstrakt:	Background and study aims Digital single-operator cholangioscopy (DSOC) allows the diagnosis of biliary duct disorders and treatment for complicated stones. However, these technologies have limitations such as the size of the probe and working channel, excessive cost, and low image resolution. Recently, a novel DSOC system (eyeMAX, Micro-Tech, Nanjing, China) was developed to address these limitations. We aimed to evaluate the usefulness and safety of a novel 9F and 11F DSOC system in terms of neoplastic diagnostic accuracy based on visual examination, ability to evaluate tumor extension and to achieve complete biliary stone clearance, and procedure-related adverse events (AEs). Patients and methods Data from ≥ 18-year-old patients who underwent DSOC from July 2021 to April 2022 were retrospectively recovered and divided into a diagnostic and a therapeutic cohort. Results A total of 80 patients were included. In the diagnostic cohort (n = 49/80), neovascularity was identified in 26 of 49 patients (46.9%). Biopsy was performed in 65.3% patients with adequate tissue sample obtained in 96.8% of cases. Biopsy confirmed neoplasia in 23 of 32 cases. DSOC visual impression achieved 91.6% sensitivity and 87.5% specificity in diagnosing neoplasms. In the therapeutic cohort (n = 43/80), 26 of 43 patients required lithotripsy alone. Total stone removal was achieved in 71% patients in the first session. Neither early nor late AEs were documented in either the diagnostic or therapeutic cohort. Conclusions The novel DSOC device has excellent diagnostic accuracy in distinguishing neoplastic biliary lesions as well as therapeutic benefits in the context of total stone removal, with no documented AEs. Competing Interests: Conflict of Interest Carlos Robles-Medranda is a key opinion leader and consultant for Pentax Medical, Steris, Medtronic, Motus, Micro-tech, G-Tech Medical Supply, CREO Medical, and mdconsgroup. Michel Kahaleh is a consultant for Boston Scientific, Interscope Med, and Abbvie; grant recipient from Boston Scientific, Conmed, Gore, Pinnacle, Merit Medical, Olympus Medical, and Ninepoint Medical; chief executive officer and founder of Innovative Digestive Health Education & Research Inc. Issac Raijman is a speaker for BostonScientific, ConMed, Medtronic, and GI Supplies; advisory board member for Micro-Tech; co-owner of EndoRx. The other authors declare no conflicts of interest. (The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).)
Databáze:	MEDLINE
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