Christian Gerges1, Alain García Vázquez2,3, Andrea Tringali4,5, Juan Manuel Verde6,7, Tobias Dertmann1, Eduardo Houghton8, Alessandro Cina5, Torsten Beyna1, Federico Sylvestre Begnis8, Margherita Pizzicannella2,3, Mariano Palermo8, Silvana Perretta2,3, Guido Costamagna4,5, Jacques Marescaux3, Horst Neuhaus1, Ivo Boškoski4,5, Mariano Eduardo Giménez2,3,8. 1. Evangelisches Krankenhaus, Düsseldorf, Germany. 2. Institute of Image-Guided Surgery, 1 place de l´Hopital, 67091, Strasbourg, France. 3. Research Institute against Digestive Cancer, IRCAD, Strasbourg University, Strasbourg, France. 4. Digestive Endoscopy Unit, Center for Endoscopic Research Therapeutics and Training (CERTT), Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy. 5. Radiology Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy. 6. Institute of Image-Guided Surgery, 1 place de l´Hopital, 67091, Strasbourg, France. juan.verde@ihu-strasbourg.eu. 7. Research Institute against Digestive Cancer, IRCAD, Strasbourg University, Strasbourg, France. juan.verde@ihu-strasbourg.eu. 8. Daicim Foundation, Training, Research, and Clinical activity in Minimally Invasive Surgery, Buenos Aires, Argentina.
Abstract
BACKGROUND AND AIMS: Percutaneous cholangioscopy (PC) is more complex and invasive than a transpapillary approach, with the need for a large percutaneous tract of 16 French (Fr) on average in order to advance standard percutaneous cholangioscopes. The aim of this study was to investigate whether percutaneous single-operator cholangioscopy (pSOC) using the SpyGlass™ DS system is feasible, safe, and effective in PC for diagnostic and therapeutic indications. MATERIALS AND METHODS: The data of 28 patients who underwent pSOC in 4 tertiary referral centers were retrospectively analyzed. Technical and clinical success for therapeutic procedures was assessed as well as diagnostic accuracy of pSOC-guided biopsies and visualization. Adverse events and the required number and size of dilatations were reviewed. RESULTS: 25/28 (89%) patients had a post-surgical altered anatomy. The average number of percutaneous dilatations prior to pSOC was 1.25 with a mean dilatation size of 11 French. Histopathology showed a 100% accuracy. Visual impression showed an overall accuracy of 96.4%. Technical and clinical success was achieved in 27/28 (96%) of cases. Adverse events occurred in 3/28 (10.7%) cases. CONCLUSION: pSOC is a feasible, safe, and effective technique for diagnostic and therapeutic indications. It may be considered an alternative approach in clinical cases where gastrointestinal anatomy is altered. It has the potential to reduce peri-procedural adverse events and costs. Prospective randomized-controlled trials are necessary to confirm the previously collected data.
BACKGROUND AND AIMS: Percutaneous cholangioscopy (PC) is more complex and invasive than a transpapillary approach, with the need for a large percutaneous tract of 16 French (Fr) on average in order to advance standard percutaneous cholangioscopes. The aim of this study was to investigate whether percutaneous single-operator cholangioscopy (pSOC) using the SpyGlass™ DS system is feasible, safe, and effective in PC for diagnostic and therapeutic indications. MATERIALS AND METHODS: The data of 28 patients who underwent pSOC in 4 tertiary referral centers were retrospectively analyzed. Technical and clinical success for therapeutic procedures was assessed as well as diagnostic accuracy of pSOC-guided biopsies and visualization. Adverse events and the required number and size of dilatations were reviewed. RESULTS: 25/28 (89%) patients had a post-surgical altered anatomy. The average number of percutaneous dilatations prior to pSOC was 1.25 with a mean dilatation size of 11 French. Histopathology showed a 100% accuracy. Visual impression showed an overall accuracy of 96.4%. Technical and clinical success was achieved in 27/28 (96%) of cases. Adverse events occurred in 3/28 (10.7%) cases. CONCLUSION: pSOC is a feasible, safe, and effective technique for diagnostic and therapeutic indications. It may be considered an alternative approach in clinical cases where gastrointestinal anatomy is altered. It has the potential to reduce peri-procedural adverse events and costs. Prospective randomized-controlled trials are necessary to confirm the previously collected data.
Authors: S K Lee; D W Seo; S J Myung; E T Park; B C Lim; H J Kim; K S Yoo; H J Park; Y H Joo; M H Kim; Y I Min Journal: Gastrointest Endosc Date: 2001-03 Impact factor: 9.427
Authors: Christian Gerges; Torsten Beyna; Raymond S Y Tang; Farzan Bahin; James Y W Lau; Erwin van Geenen; Horst Neuhaus; Duvvur Nageshwar Reddy; Mohan Ramchandani Journal: Gastrointest Endosc Date: 2019-11-25 Impact factor: 9.427
Authors: Anna Maria Ierardi; Giovanni Maria Rodà; Letizia Di Meglio; Giuseppe Pellegrino; Paolo Cantù; Daniele Dondossola; Giorgio Rossi; Gianpaolo Carrafiello Journal: J Clin Med Date: 2021-03-29 Impact factor: 4.241