Percutaneous <scp>SpyGlass</scp> cholangioscopy for treatment of intrahepatic bile duct calculi

Wright, Melissa; Chan, Justin; Rudolph, Ryan; Haghighi, Koroush S.

doi:10.1111/ans.17394

Cited by 3 publications

(3 citation statements)

References 7 publications

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“…POC could also be challenging in the case of normal anatomies and successful biliary cannulation when biliary stones are located in the more proximal biliary branches, where biliary angulations may block POC passage or may create instability during therapeutic procedures. In such situations, PC may provide valid and easier access to intrahepatic/hilar bile ducts for the treatment of biliary stones [ 94 , 95 , 96 , 97 , 98 ]. In Figure 2 , a case from our institution of an EHL for multiple intrahepatic lithiasis not reachable with POC for the presence of an inflammatory stricture below the stones is described.…”

Section: Cholangioscopy Through Different Routesmentioning

confidence: 99%

The Role of Cholangioscopy in Biliary Diseases

Mauro,

Mazza,

Scalvini

et al. 2023

Diagnostics

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Endoscopy plays a central role in diagnostic and therapeutic approaches to biliary disease in both benign and malignant conditions. A cholangioscope is an endoscopic instrument that allows for the direct exploration of the biliary tree. Over the years, technology has improved endoscopic image quality and allowed for the development of an operative procedure that can be performed during cholangioscopy. Different types of instruments are available in this context, and they can be used in different anatomical access points according to the most appropriate clinical indication. The direct visualization of biliary mucosa is essential in the presence of biliary strictures of unknown significance, allowing for the appropriate allocation of patients to surgery or conservative treatments. Cholangioscopy has demonstrated excellent performance in discriminating malignant conditions (such as colangiocarcinoma) from benign inflammatory strictures, and more recent advances (e.g., artificial intelligence and confocal laser endomicroscopy) could further increase its diagnostic accuracy. Cholangioscopy also plays a primary role in the treatment of benign conditions such as difficult bile stones (DBSs). In this case, it may not be possible to achieve complete biliary drainage using standard ERCP. Therapeutic cholangioscopy-guided lithotripsy allows for stone fragmentation and complete biliary drainage. Indeed, other complex clinical situations, such as patients with intra-hepatic lithiasis and patients with an altered anatomy, could benefit from the therapeutic role of cholangioscopy. The aim of the present review is to explore the most recent diagnostic and therapeutic advances in the roles of cholangioscopy in the management of biliary diseases.

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Section: Cholangioscopy Through Different Routesmentioning

confidence: 99%

The Role of Cholangioscopy in Biliary Diseases

Mauro,

Mazza,

Scalvini

et al. 2023

Diagnostics

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“…In addition, the heterogeneity of BDSs (stone location, size and other factors) may lead to different clinical symptoms and affect the health of patients to varying degrees[ 6 , 7 ]. At present, intra- and extrahepatic BDSs are mainly treated surgically, but the success rate of surgery is not satisfactory, and there is a risk of postoperative complications[ 8 ]. Therefore, it is necessary to optimize the surgical treatment of intra- and extrahepatic BDSs, which is highly important for improving the treatment experience of such patients.…”

Section: Introductionmentioning

confidence: 99%

Comparison of the clinical effects of dual-modality endoscopy and traditional laparotomy for the treatment of intra- and extrahepatic bile duct stones

Wang,

Xia,

Dai

2024

World J Gastrointest Surg

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BACKGROUND Bile duct stones (BDSs) may cause patients to develop liver cirrhosis or even liver cancer. Currently, the success rate of surgical treatment for intrahepatic and extrahepatic BDSs is not satisfactory, and there is a risk of postoperative complications. AIM To compare the clinical effects of dual-modality endoscopy (duodenoscopy and laparoscopy) with those of traditional laparotomy in the treatment of intra- and extrahepatic BDSs. METHODS Ninety-five patients with intra- and extrahepatic BDSs who sought medical services at Wuhan No.1 Hospital between August 2019 and May 2023 were selected; 45 patients in the control group were treated by traditional laparotomy, and 50 patients in the research group were treated by dual-modality endoscopy. The following factors were collected for analysis: curative effects, safety (incision infection, biliary fistula, lung infection, hemobilia), surgical factors [surgery time, intraoperative blood loss (IBL) volume, gastrointestinal function recovery time, and length of hospital stay], serum inflammatory markers [tumor necrosis factor (TNF)-α, interleukin (IL)-6, and IL-8], and oxidative stress [glutathione peroxidase (GSH-Px), superoxide dismutase (SOD), malondialdehyde (MDA), and advanced protein oxidation products (AOPPs)]. RESULTS The analysis revealed markedly better efficacy (an obviously higher total effective rate) in the research group than in the control group. In addition, an evidently lower postoperative complication rate, shorter surgical duration, gastrointestinal function recovery time and hospital stay, and lower IBL volume were observed in the research group. Furthermore, the posttreatment serum inflammatory marker (TNF-α, IL-6, and IL-8) levels were significantly lower in the research group than in the control group. Compared with those in the control group, the posttreatment GSH-Px, SOD, MDA and AOPPs in the research group were equivalent to the pretreatment levels; for example, the GSH-Px and SOD levels were significantly higher, while the MDA and AOPP levels were lower. CONCLUSION Dual-modality endoscopy therapy (duodenoscopy and laparoscopy) is more effective than traditional laparotomy in the treatment of intra- and extrahepatic BDSs and has a lower risk of postoperative complications; significantly shortened surgical time; shorter gastrointestinal function recovery time; shorter hospital stay; and lower intraoperative bleeding volume, while having a significant inhibitory effect on excessive serum inflammation and causing little postoperative oxidative stress.

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“…Wright et al present a case of a patient with Bismuth type E3 bile duct injury that was managed with Roux-en-Y reconstruction; however, eventually, the patient developed intrahepatic calculi. 1 The patient was successfully treated with two sessions of percutaneous cholangioscopy to remove the calculi with the help of electrohydraulic lithotripsy. In the discussion, the authors mention that only similar case reports or small case series (largest, n = 4) have been published in the literature describing the use of percutaneous cholangioscopy for the management of intrahepatic calculi in the setting of altered surgical anatomy in the abdomen like hepaticojejunal reconstruction.…”

mentioning

confidence: 99%

Percutaneous cholangioscopy for the management of intrahepatic calculi in the setting of altered abdominal anatomy

Garg

2022

ANZ Journal of Surgery

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Percutaneous SpyGlass cholangioscopy for treatment of intrahepatic bile duct calculi

Cited by 3 publications

References 7 publications

The Role of Cholangioscopy in Biliary Diseases

The Role of Cholangioscopy in Biliary Diseases

Comparison of the clinical effects of dual-modality endoscopy and traditional laparotomy for the treatment of intra- and extrahepatic bile duct stones

Percutaneous cholangioscopy for the management of intrahepatic calculi in the setting of altered abdominal anatomy

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