BACKGROUND: Single-operator cholangioscopy enables direct diagnostic visualization and therapeutic intervention in the biliary tree. There is increasing evidence of its clinical utility in the assessment of biliary strictures and treatment of difficult stones. OBJECTIVE: To describe the first reported Canadian experience with managing biliary disease using single-operator cholangioscopy. METHODS: The present study was a retrospective analysis of data collected from all sequential patients undergoing single-operator cholangioscopy for assessment of biliary strictures and treatment of biliary stones. The main outcome measures were the ability to make an overall diagnosis of stricture (based on visual appearances and tissue histology), and to fragment and extract biliary stones. RESULTS: Thirty patients (17 women), mean age 66 years (range 41 to 89 years) underwent single-operator cholangioscopy. In biliary strictures (20 patients), overall accuracy for visual and tissue diagnosis was 84% and 81%, respectively. Successful electrohydraulic lithotripsy with stone clearance was achieved in 90% of the 10 patients who failed previous conventional therapy. The mean (± SD) procedure time was 61±21 min (range 20 min to 119 min). One patient developed mild postendoscopic retrograde cholangioscopy pancreatitis. CONCLUSION: The results of this experience reaffirms the clinical utility and safety of single-operator cholangioscopy for the management of biliary pathology. Further improvements can be achieved with increasing operator experience and refinements in optical technology.
BACKGROUND: Single-operator cholangioscopy enables direct diagnostic visualization and therapeutic intervention in the biliary tree. There is increasing evidence of its clinical utility in the assessment of biliary strictures and treatment of difficult stones. OBJECTIVE: To describe the first reported Canadian experience with managing biliary disease using single-operator cholangioscopy. METHODS: The present study was a retrospective analysis of data collected from all sequential patients undergoing single-operator cholangioscopy for assessment of biliary strictures and treatment of biliary stones. The main outcome measures were the ability to make an overall diagnosis of stricture (based on visual appearances and tissue histology), and to fragment and extract biliary stones. RESULTS: Thirty patients (17 women), mean age 66 years (range 41 to 89 years) underwent single-operator cholangioscopy. In biliary strictures (20 patients), overall accuracy for visual and tissue diagnosis was 84% and 81%, respectively. Successful electrohydraulic lithotripsy with stone clearance was achieved in 90% of the 10 patients who failed previous conventional therapy. The mean (± SD) procedure time was 61±21 min (range 20 min to 119 min). One patient developed mild postendoscopic retrograde cholangioscopy pancreatitis. CONCLUSION: The results of this experience reaffirms the clinical utility and safety of single-operator cholangioscopy for the management of biliary pathology. Further improvements can be achieved with increasing operator experience and refinements in optical technology.
Authors: Evangelos Kalaitzakis; George J Webster; Kofi W Oppong; Yiannis Kallis; Panagiotis Vlavianos; Matthew Huggett; Muhammad F Dawwas; Venkata Lekharaju; Adrian Hatfield; David Westaby; Richard Sturgess Journal: Eur J Gastroenterol Hepatol Date: 2012-06 Impact factor: 2.566
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Authors: A Fritscher-Ravens; D C Broering; W T Knoefel; X Rogiers; P Swain; F Thonke; C Bobrowski; T Topalidis; N Soehendra Journal: Am J Gastroenterol Date: 2004-01 Impact factor: 10.864
Authors: Thomas Rösch; Kim Hofrichter; Eckart Frimberger; Alexander Meining; Peter Born; Norbert Weigert; Hans-Dieter Allescher; Meinhard Classen; Marius Barbur; Ulrich Schenck; Martin Werner Journal: Gastrointest Endosc Date: 2004-09 Impact factor: 9.427
Authors: M F Byrne; H Gerke; R M Mitchell; H L Stiffler; K McGrath; M S Branch; J Baillie; P S Jowell Journal: Endoscopy Date: 2004-08 Impact factor: 10.093
Authors: Facundo Galetti; Diogo Turiani Hourneaux de Moura; Igor Braga Ribeiro; Mateus Pereira Funari; Martin Coronel; Amit H Sachde; Vitor Ottoboni Brunaldi; Tomazo Prince Franzini; Wanderley Marques Bernardo; Eduardo Guimarães Hourneaux de Moura Journal: Arq Bras Cir Dig Date: 2020-06-26