The utility of digital cholangioscopy (SpyGlass DS) in biliary and pancreatic diseases: A clinical feasibility study at two tertiary care centers in Saudi Arabia (with Videos)
| Autor: | Ahmad AlEid, Abdullah Al Khathlan, Thamer Almasoudi, Shameem Ahmad, Nawwaf Al Otaibi, Khalid Al Sayari, Adel Qutub, Ahmed Al Ghamdi, Emad Aljahdali, Abed Al Lehibi, Areej Al Balkhi, Abdullah Al Mtawa |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Adult
Male medicine.medical_specialty Biliary Tract Diseases Technical success Saudi Arabia Tertiary care Tertiary Care Centers 03 medical and health sciences 0302 clinical medicine Histological diagnosis Biopsy medicine Humans Aged Retrospective Studies Cholangiopancreatography Endoscopic Retrograde Endoscopic retrograde cholangiopancreatography medicine.diagnostic_test business.industry General surgery Gastroenterology Pancreatic Diseases Reproducibility of Results Middle Aged First generation Safety profile 030220 oncology & carcinogenesis Feasibility Studies Female 030211 gastroenterology & hepatology Extraction methods business |
| Zdroj: | Arab Journal of Gastroenterology. 21:49-53 |
| ISSN: | 1687-1979 |
| Popis: | Background and study aim Since its inception in 2007, single-operator cholangioscopy (SOC) has gained popularity for many diagnostically and therapeutically challenging biliary and pancreatic conditions. Many studies have been published to evaluate the feasibility, usefulness, cost-effectiveness, and safety profile of the first generation. This paper is a descriptive study in which we aim to share the experience of two tertiary care centers with the novel version of SOC, SpyGlass DS. Patients and methods We retrospectively reviewed the records of all the patients who went through the procedure from October 2015 - July 2019 to explore the scope of biliary and pancreatic conditions in which SOC was utilized. Technical success was defined as the ability to visualize the lesion and complete the procedure as planned, whereas clinical success was determined by the ability to achieve the desired diagnostic/therapeutic outcome. Results During the period of interest, 66 patients (34 males) went through 84 cholangioscopy procedures. Forty-four patients failed the conventional extraction methods and needed the intervention for the treatment of difficult stones, 24 patients needed a diagnostic evaluation of biliary strictures, and 3 needed an intervention to remove migrated stents. Technical success was achieved in 98.8% (83/84) of the procedures (95% CI: 96–100%). Regarding clinical success, stone breakdown and removal was achieved in 92% of the procedures (49/53; 95% CI: 85–100%). Tissue samples were successfully obtained in 95.8% (23/24) of patients with strictures (95% CI: 88–100%). The biopsy was appropriate to make a histological diagnosis in 83.3% of cases (20/24; 95% CI: 68–98%). The median number of sessions needed to achieve the deisred outcome was one (ranging between 1 and 6 sessions). Conclusion The new version of SOC, SpyGlass DS, provides a feasible and an effective option for the management of difficult cholelithiasis, as well as visually evaluating and obtaining histological samples for indeterminate biliary strictures. However, data from more extensive studies are needed to establish its non-inferiority to the fiberoptic version in terms of short- and long-term outcomes, cost-effectiveness, and complications. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect