title: Spyglass single-operator peroral cholangioscopy seems promising in the evaluation of primary sclerosing cholangitis-related biliary strictures.
abstract: Early diagnosis of dysplastic changes and exclusion of cholangiocarcinoma (CCA) in patients with primary sclerosing cholangitis (PSC) remain a major clinical challenge. Although SpyGlass single-operator cholangioscopy (SOC) appears effective in diagnostics of indeterminate biliary strictures, there are only few studies on its safety in PSC-related strictures.
  
  
  OBJECTIVE
  The aim of this study was to assess the clinical feasibility of SOC and directed biopsies, flow cytometry, and brush cytology in PSC patients.
  
  
  METHODS
  Eleven consecutive patients (median age 45 years, 5 females) undergoing SOC for progression of PSC in a single tertiary center were included in a prospective observational study.
  
  
  RESULTS
  Brush sample and directed biopsies were successfully acquired from strictures in all cases. Samples were adequate for cytological and histological diagnosis in 9 (82%) and 10 patients (91%), respectively. There were two cases of pancreatitis. In one patient, flow cytometry showed aneuploidy, which resulted in closer follow-up.
  
  
  CONCLUSIONS
  SpyGlass SOC and directed biopsies seem to offer a feasible and promising method in evaluation of PSC-related strictures. However, the long-term prognostic value it adds to cytology and flow cytometry remains to be assessed in future trials.
authors.affiliation: Department of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital , Tampere , Finland.
authors.forename: Antti
authors.initials: A
authors.lastname: Siiki
authors.forename: Irina
authors.initials: I
authors.lastname: Rinta-Kiikka
authors.forename: Tarmo
authors.initials: T
authors.lastname: Koivisto
authors.forename: Kaija
authors.initials: K
authors.lastname: Vasama
authors.forename: Juhani
authors.initials: J
authors.lastname: Sand
authors.forename: Johanna
authors.initials: J
authors.lastname: Laukkarinen
mesh_terms: D000328:Adult; D000368:Aged; D049448:Cholangiopancreatography, Magnetic Resonance / Q000379:methods*; D015209:Cholangitis, Sclerosing / Q000150:complications* / Q000175:diagnosis; D002780:Cholestasis, Intrahepatic / Q000175:diagnosis* / Q000209:etiology; D003937:Diagnosis, Differential; D018450:Disease Progression; D020776:Endoscopes, Gastrointestinal; D016145:Endoscopy, Digestive System / Q000295:instrumentation*; D004867:Equipment Design; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015203:Reproducibility of Results; D055815:Young Adult
keywords: Benign biliary strictures; cholangioscopy; endoscopic retrograde cholangio-pancretography; primary sclerosing cholangitis