A Preoperative Diagnosis of Advanced Cystic Duct Carcinoma Using SpyGlass DS Cholangioscopy: A Report of Two Cases

Abstract

Primary cystic duct carcinoma is a rare tumor. The curative treatment of cystic duct carcinoma is complete surgical resection, for which the evaluation of local extension is important. We herein report two cases of cystic duct carcinoma in which a preoperative examination was performed using per-oral cholangioscopy (POCS). Both patients underwent POCS due to suspicion of cystic duct carcinoma based on imaging findings. A visual analysis and biopsy were performed to evaluate local extension, which led to surgery. These cases suggest that POCS is useful for the preoperative assessment of local extension in advanced cystic duct carcinoma.

Intraoperative transcystic laparoscopic common bile duct stone clearance with SpyGlass™ discover during emergency and elective cholecystectomy: a single-center case series

“…The SpyGlass™ incorporates a perfusion channel to retain a good field of view and a greater optical resolution than traditional bile duct scopes. Additionally, it has a four-way angle which allows to easily visualize narrow and intricate ducts, such as the cystic and intrahepatic bile ducts [ 9 ]. The characteristics of SpyGlass™ Discover allows the percutaneous or laparoscopic transcystic exploration of CBD and the CBDS removal.…”

“…Recently, there have been several reports regarding the peroral use of the SpyGlass™ DS for the diagnosis of indeterminate biliary stricture [ 8 ] and cystic duct neoplasm [ 9 ]. Furthermore, the use of SpyGlass™ technology for single-operator transpapillary [ 10 ] or percutaneous [ 11 ] cholangioscopy for removing difficult stones has been described too.…”

“…In recent years, the development of a new cholangioscope, the SpyGlass ™ Discover (Boston Scientific) [8][9][10][11][12] with an outer diameter of 3.5 mm, has allowed the laparoscopic transcystic CBD exploration and CBDS clearance. The possibility of simultaneous treatment of CBDS with SpyGlass ™ Discover, after intraoperative cholangiography (IOC), during ELC offers the opportunity to enormously reduce the time between ACC diagnosis and the execution of ELC with better outcomes for these patients.…”

Intraoperative transcystic laparoscopic common bile duct stone clearance with SpyGlass™ Discover during emergency and elective cholecystectomy: a single-center case series

“…The SpyGlass™ incorporates a perfusion channel to retain a good eld of view and a greater optical resolution than traditional bile duct scopes. Additionally, it has a four-way angle which allows to easily visualize narrow and intricate ducts, such as the cystic and intrahepatic bile ducts (9). The characteristics of SpyGlass™ Discover allows the percutaneous or laparoscopic transcystic exploration of CBD and the CBDS removal.…”

“…Recently, there have been several reports regarding the peroral use of the SpyGlass™ DS for the diagnosis of indeterminate biliary stricture (8) and cystic duct neoplasm (9). Furthermore, the use of SpyGlass™ technology for single-operator trans-papillary (10) or percutaneous (11) cholangioscopy for removing di cult stones has been described too.…”