SpyGlass cholangioscopy for management of choledocholithiasis during pregnancy

Uradomo, Lance; Pandolfe, Frank; Aragon, George; Borum, Marie

doi:10.1016/s1499-3872(11)60017-9

Cited by 16 publications

(7 citation statements)

References 4 publications

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“…26 No 2: 165-170 also been used successfully in a patient with choledocholithiasis and Roux-en-Y anatomy [33]. Another relevant therapeutic application for SpyGlass® has been the management of choledocholithiasis during pregnancy in the first trimester [34], due to the elimination of radiation exposure during stone removal.…”

Section: Therapeutic Applicationsmentioning

confidence: 99%

Peroral Cholangiopancreatoscopy with the SpyGlass® System: What do we Know 10 Years Later

Pereira

Peixoto

Andrade

et al. 2017

JGLD

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Smaller endoscopes and catheters have been developed that permit direct visualization of the bile and pancreatic ducts (cholangioscopy and pancreatoscopy, respectively). These endoscopes and catheters are passed through the working channel of a standard therapeutic duodenoscope during endoscopic retrograde cholangiopancreatography (ERCP). The SpyGlass Direct Visualization System (Boston Scientific Corp, Natick, MA, USA) is currently the most widely used and studied device. Cholangioscopy with intraductal lithotripsy has become an established modality in the treatment of difficult biliary lithiasis. When used in the evaluation of indeterminate biliary strictures by experienced endoscopists in recognizing intraductal pathology, it increases the diagnostic yield of tissue sampling. Pancreatoscopy is complementary to other imaging modalities in the evaluation of intraductal papillary mucinous neoplasms of the pancreas and is emerging as a sole or adjunctive therapy to extracorporeal shock wave lithotripsy for the treatment of main pancreatic duct stones. It remains investigational in the diagnosis of pancreatic adenocarcinoma. Complications specific to the performance of cholangiopancreatoscopy include cholangitis, which is related to intraductal fluid irrigation.Abbreviations: EHL: Electrohydraulic lithotripsy; ERCP: Endoscopic retrograde cholangiopancreatography; ESWL: Extracorporeal lithotripsy by shock waves; ET: Endoscopic therapy; EUS: Endoscopic ultrasound; IPMN: intraductal papillary mucinous neoplasm; LL: Laser lithotripsy; MDCT: Multi-detector computed conventional tomography; MPD: Main pancreatic duct; MRCP: Magnetic resonance cholangiopancreatography; MRI: Magnetic resonance imaging; POCPS: Peroral cholangiopancreatoscopy; PSC: Primary sclerosing cholangitis

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Section: Therapeutic Applicationsmentioning

confidence: 99%

Peroral Cholangiopancreatoscopy with the SpyGlass® System: What do we Know 10 Years Later

Pereira

Peixoto

Andrade

et al. 2017

JGLD

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“…Clinical reports on peroral choledochoscopy management of gallstone during pregnancy are rare. Peroral cholangioscopy, especially the SpyGlass Direct Visualization System (Boston Scientific, Natick, MA, USA), was used in the confirmation of biliary cannulation and documentation of stone clearance without the need for fluoroscopy . This new single‐operator system addresses many shortcomings of the mother–baby choledochoscopes that require two skilled endoscopists, have limited tip deflection, lack dedicated irrigation capabilities, and are fragile and prone to breakage of the fiberoptic camera .…”

Section: Peroral Choledochoscopy‐guided Ercpmentioning

confidence: 99%

“…Peroral cholangioscopy, especially the SpyGlass Direct Visualization System (Boston Scientific, Natick, MA, USA), was used in the confirmation of biliary cannulation and documentation of stone clearance without the need for Digestive Endoscopy 2014; 26: 691-700 Non-radiation ERCP during pregnancy 697 fluoroscopy. 12,51,78 This new single-operator system addresses many shortcomings of the mother-baby choledochoscopes that require two skilled endoscopists, have limited tip deflection, lack dedicated irrigation capabilities, and are fragile and prone to breakage of the fiberoptic camera. 79 The Spy-Glass system which is compatible with standard therapeutic duodenoscopes is a safe and effective procedure for diagnosing biliary diseases in non-pregnant patients and has also been useful in the small number of pregnant patients with choledocholithiasis that have been reported.…”

Section: Peroral Choledochoscopy-guided Ercpmentioning

confidence: 99%

Non‐radiation endoscopic retrograde cholangiopancreatography in the management of choledocholithiasis during pregnancy

Faigel

Yang

2014

Digestive Endoscopy

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Gallstone diseases are common during pregnancy. In most cases, patients are asymptomatic and do not require any treatment. However, choledocholithiasis, cholangitis, and gallstone pancreatitis may potentially become life-threatening for both mother and fetus and often require urgent intervention. Although endoscopic retrograde cholangiopancreatography (ERCP) has become the standard technique for removing common bile duct stones, it is associated with ionizing radiation that could carry teratogenic risk. Non-radiation ERCP (NR-ERCP) is reported to be effective without incurring this risk. Two techniques have been described to confirm bile duct cannulation: bile aspiration and image guidance. With bile aspiration, biliary cannulation is confirmed by applying suction to the cannula to yield bile, thus confirming an intrabiliary position. Image guidance involves using ultrasound or direct visualization (choledochoscopy) to confirm selective biliary cannulation or duct clearance. Once cannulation is achieved, the stones are removed using standard ERCP techniques and tools. Case series and retrospective studies have reported success rates of up to 90% for NR-ERCP with complication rates similar to standard ERCP. Pregnancy outcomes are not adversely affected by NR-ERCP, but whether the avoidance of radiation carries benefit for the baby is unknown. Prospective comparative trials are lacking. NR-ERCP is technically demanding and should be attempted only by skilled biliary endoscopists in properly equipped and staffed health-care institutions, in a multidisciplinary setting.

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“…The diagnostic and therapeutic capability of ERCP is increased in a manner that contributes to patient safety and hopefully better maternal and fetal outcomes. So more studies are needed of this technique during pregnancy to asses the fetal outcomes [4,[114][115][116].…”

Section: Endoscopic Spyscopymentioning

confidence: 99%

Endoscopy in Pregnant Patients

Savas¹

2013

Endoscopy

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SpyGlass cholangioscopy for management of choledocholithiasis during pregnancy

Cited by 16 publications

References 4 publications

Peroral Cholangiopancreatoscopy with the SpyGlass® System: What do we Know 10 Years Later

Peroral Cholangiopancreatoscopy with the SpyGlass® System: What do we Know 10 Years Later

Non‐radiation endoscopic retrograde cholangiopancreatography in the management of choledocholithiasis during pregnancy

Endoscopy in Pregnant Patients

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