Cholangiocarcinoma obscured by a large paraesophageal hernia causing traction compression of the common hepatic duct ultimately diagnosed with percutaneous cholangioscopy

Tejaswi, Sooraj; Louie, Justin; Loehfelm, Thomas W.; Jenner, Zachary B.; Reichert, Sonia; Mitra, Ananya; Gholami, Sepideh; Pillai, Rex

doi:10.1016/j.vgie.2021.12.001

Cited by 2 publications

(1 citation statement)

References 6 publications

(14 reference statements)

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“…Although the existing studies do not provide enough data for comparison, Chon et al [22] concluded that for Spyglass a mean of 2 sessions of PerC were necessary, compared to a mean of 5.12 sessions with an old-generation cholangioscope [23]. The explanation for this is uncertain, but might relate to the use of narrower-caliber 10-Fr cholangioscopes, allowing greater scope maneuverability and facilitating access to smaller bore ducts [42][43][44].…”

Section: Studiesmentioning

confidence: 99%

Performance and safety of percutaneous cholangioscopy: a systematic review and meta-analysis

Papaefthymiou,

Gkolfakis,

Basiliya

et al. 2023

ESGE Days 2023

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Background Percutaneous cholangioscopy (PerC) offers an alternative for patients with an inaccessible biliary tree. This systematic review and meta-analysis aimed to evaluate the performance of this technique.Methods A search in Medline, Cochrane and ClinicalTrials.gov databases was performed for studies assessing PerC up to October 2022. The primary outcome was diagnostic success, defined as successful stone identification or stricture workup. Secondary outcomes included therapeutic success (stone extraction, stenting) and complication rate. A subgroup analysis compared previous-generation and modern cholangioscopes. We performed meta-analyses using a randomeffects model and the results were reported as percentages with 95% confidence interval (CI).Results Fourteen studies (682 patients) were eligible for analysis. The rate of diagnostic success was 98.7% (95%CI 97.6-99.8%; I 2 =31.19%) and therapeutic success was 88.6% (95%CI 82.8-94.3%; I 2 =74.92%). Adverse events were recorded in 17.1% (95%CI 10.7-23.5%; I 2 =77.56%), of which 15.9% (95%CI 9.8-21.9%; I 2 =75.98%) were minor and 0.6% (95%CI 0.1-1.2%; I 2 =0%) major. The Spyglass system showed null heterogeneity for all outcomes; compared with older-generation endoscopes it offered comparable diagnostic success, but yielded significantly superior therapeutic success (96.1%, 95%CI 90-100%; I 2 =0% vs. 86.4%, 95%CI 79.2-93.6%; I 2 =81.41%; P=0.02]. ConclusionPerC, especially using currently available cholangioscopes, is associated with high diagnostic and therapeutic success.

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