Cholangiopancreatoscopy

Komanduri, Sri; Thosani, Nirav; Dayyeh, Barham K. Abu; Aslanian, Harry R.; Enestvedt, Brintha K.; Manfredi, Michael A.; Maple, John T.; Navaneethan, Udayakumar; Pannala, Rahul; Parsi, Mansour A.; Smith, Zachary L.; Sullivan, Shelby; Banerjee, Subhas

doi:10.1016/j.gie.2016.03.013

Cited by 78 publications

(60 citation statements)

References 127 publications

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“…The specific role for MAIT cells in the pathogenesis of PSC is currently unclear. However, the possibility to assess bile duct MAIT cells together with recent technological development within cholangioscopic methods will allow for future studies dissecting this in more detail.…”

Section: Resultsmentioning

confidence: 99%

Primary sclerosing cholangitis leads to dysfunction and loss of MAIT cells

et al. 2018

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Primary sclerosing cholangitis (PSC) is a severe chronic liver disease of the small and large bile ducts. The pathogenesis is unknown but a strong immune cell component has been suggested. Mucosal-associated invariant T (MAIT) cells are abundant in human liver and localize around bile ducts. Yet, the role of MAIT cells in PSC remains unclear.Here, we performed a detailed characterization of MAIT cells in circulation and assessed their presence in bile ducts of PSC patients as well as non-PSC controls. We observed a dramatic reduction in MAIT cell levels in PSC patients. High-dimensional phenotypical analysis using stochastic neighbor embedding revealed the MAIT cells to be activated, a phenotype shared by the investigated disease control groups. In line with the noted phenotypic alterations, MAIT cell function was reduced in response to Escherichia coli and to cytokine stimulation in PSC patients as compared to healthy controls. Using a novel sampling approach of human bile ducts, we found MAIT cells to be specifically enriched within bile ducts. Finally, distinct from the dramatic decline observed in circulation, PSCpatients had retained levels of MAIT cells within bile ducts. Altogether, our results provide a detailed insight into how the human MAIT cell compartment is affected in PSC.Keywords: Gut-liver axis r Inflammation r Inflammatory bowel disease r Mucosal-associated invariant T cells r Primary sclerosing cholangitis Additional supporting information may be found online in the Supporting Information section at the end of the article.

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Section: Resultsmentioning

confidence: 99%

Primary sclerosing cholangitis leads to dysfunction and loss of MAIT cells

et al. 2018

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“…The currently available instruments for endoscope-based cholangiopancreatoscopy in the United States are the following [6]:…”

Section: Endoscope-based Systemsmentioning

confidence: 99%

“…operators in a large number of cases [6,[9][10][11]. These limitations along with improved new systems have gradually eliminated the need for endoscope-based systems.…”

Section: Endoscope-based Systemsmentioning

confidence: 99%

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Applications of Cholangiopancreatoscopy in Pancreaticobiliary Diseases

Sánchez-Luna¹,

Parasher²

2019

Endoscopy - Novel Techniques and Recent Advancements

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Recent advances in imaging technology provide improved direct visualization of the common bile duct (CBD) and pancreatic duct (PD) using small caliber endoscopes and thus allow a wide array of therapeutic interventions. This chapter will review the technique of cholangiopancreatoscopy (CP), indications, effectiveness, and complications as well as the current commercially available options. We will discuss various methods of diagnostic and therapeutic cholangioscopy such as intraductal tissue sampling and biopsy in patients with indeterminate biliary strictures along with its role in the management of difficult bile duct stones. Finally, we will also analyze the role of pancreatoscopy in the evaluation of suspected neoplasms of the pancreas, assessment of pancreatic duct (PD) strictures, and in the treatment of pancreatic duct stones.

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“…Stone fragmentation can be performed under direct vision using either electrohydraulic lithotripsy (EHL) or laser lithotripsy (LL) probes passed down the therapeutic channel. Published series suggest stone clearance using EHL in 74%–95% of patients 17. Early experience from the UK has shown that in patients in whom conventional ERCP was unsuccessful, Spyglass DS and EHL led to complete stone clearance in 81% of cases 18.…”

Section: Recent Advancesmentioning

confidence: 99%

Endoscopic management of biliary stone disease

Wilson

Webster

2017

Frontline Gastroenterol

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The management of bile duct stone disease is the most common indication for endoscopic retrograde cholangio-pancreatography (ERCP). The majority of cases may be resolved using standard approaches including endoscopic sphincterotomy and balloon stone extraction. Recent advances in the management of large or challenging stones has come from the clear evidence for the role of endoscopic papillary large balloon dilatation (EPLBD)/sphincteroplasty and the development of cholangioscopically directed lithotripsy. Perhaps the greatest improvement in endoscopic stone management will be achieved through the implementation of plans for more formalised training, reflection and audit of ERCP performance indicators and network-wide coordination of ERCP services.

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Cholangiopancreatoscopy

Cited by 78 publications

References 127 publications

Primary sclerosing cholangitis leads to dysfunction and loss of MAIT cells

Primary sclerosing cholangitis leads to dysfunction and loss of MAIT cells

Applications of Cholangiopancreatoscopy in Pancreaticobiliary Diseases

Endoscopic management of biliary stone disease

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