Assessing the utility, findings, and outcomes of percutaneous transhepatic cholangioscopy with SpyglassTM Direct visualization system: a case series

Tripathi, Nishant; Mardini, Houssam; Koirala, Niki; Raissi, Driss; Ali, Saad M. Emhmed; Frandah, Wesam

doi:10.21037/tgh.2019.11.11

Cited by 18 publications

(21 citation statements)

References 14 publications

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“…Five cases of the PTC approach were reported with promising results; three of them were performed after Roux-en-Y HJ. In this series, just as in our case, PTC was performed given the unsuccess of the endoscopic approach – the first-line therapy for HJ dilatation [5]. PTC can offer both diagnostic and therapeutic options such as evaluation of biliary strictures, biopsies, lithotripsy, biliary stones removal, and also allow complete cleaning of the biliary ducts.…”

mentioning

confidence: 97%

Percutaneous Transhepatic Cholangioscopy and Lithotripsy of Intrahepatic Stones

Madeira-Cardoso

Almeida

Correia

et al. 2020

GE Port J Gastroenterol

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confidence: 97%

Percutaneous Transhepatic Cholangioscopy and Lithotripsy of Intrahepatic Stones

Madeira-Cardoso

Almeida

Correia

et al. 2020

GE Port J Gastroenterol

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“…Although the authors showed the feasibility, safety, and high accuracy of the procedure, their results were limited because of the lack of follow-up of outcomes and the noninclusion of cases with bile duct stones which were present in our study. Tripathi et al 17 reported that procedures involving five patients with Roux-en-Y reconstruction managed with SpyDS-guided PTCS were technically successful and did not result in any adverse events. The authors suggested that SpyDS-guided PTCS may be considered for various diagnostic and therapeutic indications, including biliary stricture management, biliary tract biopsy, bile duct stone removal, and undiagnosed biliary stasis evaluation, particularly in patients with a surgically altered anatomy.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and Safety of Percutaneous Transhepatic Cholangioscopy with the Spyglass DS Direct Visualization System in Patients with Surgically Altered Anatomy: A Pilot Study

et al. 2022

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Background/Aims: Percutaneous transhepatic cholangioscopy (PTCS) is used for the diagnosis and treatment of biliary diseases in patients with failed endoscopic retrograde cholangiopancreatography, particularly those with surgically altered anatomy. However, few studies are available on the clinical use of Spyglass DS direct visualization system (SpyDS)-assisted PTCS. This study aimed to assess the efficacy and safety of SpyDS-assisted PTCS in patients with surgically altered anatomy, particularly those with a Roux-en-Y reconstruction.Methods: Thirteen patients (six women, median age 71.4 years [range, 53 to 83 years]) with surgically altered anatomy (four Roux-en-Y choledochojejunostomies, seven Roux-en-Y hepaticojejunostomies, and two Roux-en-Y esophagojejunostomies) who underwent SpyDS-assisted PTCS between January 2019 and August 2020 were included and the data was acquired by retrospectively reviewing electronic medical record.Results: A total of 19 SpyDS-assisted PTCS procedures were performed in the 13 patients: eight had bile-duct stones, and five had biliary strictures. All SpyDS-assisted PTCS procedures were successfully performed. The total procedure time was 42.42±18.0 minutes (mean±standard deviation). Bile duct clearance was achieved in all bile duct stone cases after a median of 2 (range, 1 to 3) procedures. In the five biliary stricture cases, the results of SpyBite forceps-guided targeted biopsy were consistent with adenocarcinoma (100% accuracy). The median hospitalization duration was 20 days (range, 14 to 30 days). No procedure-related morbidity or mortality occurred.Conclusions: SpyDS-assisted PTCS may be a safe, feasible, and effective procedure for the diagnosis and treatment of biliary diseases in patients with surgically altered anatomy, particularly in those with the Roux-en-Y reconstruction requiring a percutaneous approach. However, our findings need to be validated in further studies.

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“…9 Recently, percutaneous transhepatic cholangioscopy (PTCS) with Spyglass Direct visualization system has been described, which allows access to the biliary tree with direct visualization and sampling of the bile duct via cholangioscopy, and additionally facilitates optically guided intraductal fragmentation and clearance of biliary calculi. 10 Tsutsumi et al have compared treatment methods for bile duct stones after hepaticojejunostomy between percutaneous transhepatic cholangioscopy (PTCS) and peroral, short double-balloon enteroscopy (sDBE). Forty consecutive patients were treated for bile duct stones after hepaticojejunostomy.…”

Section: Discussionmentioning

confidence: 99%

Percutaneous Transhepatic Laser Lithotripsy for Biliary Stones in Patients with Altered Biliary Anatomy

Jacob

Kheda

Bolbandi

et al. 2021

Journal of Clinical Interventional Radiology ISVIR

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Endoscopic retrograde cholangiopancreatography (ERCP) is the current treatment of choice in bile duct stones. Several factors such as variant anatomy of ampulla and surgical procedures like hepaticojejunostomy limit the success of ERCP in treating bile duct stones. Percutaneous transhepatic laser lithotripsy using interventional radiologic and endourologic techniques, which is uncommon, is a reasonable treatment option in such difficult cases. It is a minimally invasive, safe procedure accompanied by a high success rate, minimal morbidity, and a short hospital stay. We report our technique and experience in a series of three patients who underwent percutaneous transhepatic biliary drainage (PTBD) followed by percutaneous transhepatic laser lithotripsy in an attempt to avoid open surgery when ERCP was technically difficult.

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Assessing the utility, findings, and outcomes of percutaneous transhepatic cholangioscopy with SpyglassTM Direct visualization system: a case series

Cited by 18 publications

References 14 publications

Percutaneous Transhepatic Cholangioscopy and Lithotripsy of Intrahepatic Stones

Percutaneous Transhepatic Cholangioscopy and Lithotripsy of Intrahepatic Stones

Efficacy and Safety of Percutaneous Transhepatic Cholangioscopy with the Spyglass DS Direct Visualization System in Patients with Surgically Altered Anatomy: A Pilot Study

Percutaneous Transhepatic Laser Lithotripsy for Biliary Stones in Patients with Altered Biliary Anatomy

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