title: A feasibility study of digital single-operator cholangioscopy for diagnostic and therapeutic procedure (with videos).
abstract: Recently, the novel SpyGlass DS Direct Visualization system (SPY DS) has become available. This system offers several advantages over the conventional SPYGlass system. This study evaluated the clinical feasibility and efficacy of diagnostic and therapeutic procedures for biliary disorder using SPY DS.In this retrospective study, consecutive patients who had biliary disorder were enrolled between November 2015 and February 2016. All patients could not be diagnosed or treated by standard endoscopic retrograde cholangiopancreatography in our hospital or at another hospital.A total of 28 consecutive patients (21 men and 7 women; median age, 73 years; age range, 55-87 years) were retrospectively enrolled in this study. Among them, diagnostic procedure was performed in 20 patients, and 8 patients underwent therapeutic procedures. The technical success rate for diagnostic procedures was 100% (20/20). Diagnostic accuracy was 100% (19/19). The technical success rate for therapeutic procedures was 88% (7/8). Among these 8 patients, 4 patients with common bile duct stones underwent electrohydraulic lithotripsy. One patient successfully underwent guidewire insertion to remove a migrated plastic stent. The 3 remaining patients underwent SPY DS to insert a guidewire for left bile duct obstruction and for posterior bile duct branch. In the patient who underwent guidewire insertion for left hepatic bile duct obstruction cause by primary sclerosing cholangitis, we could not advance the guidewire into the left hepatic bile duct. No adverse events were seen. Median SPY DS insertion time was 21 min (range, 8-32 min).Single-operator cholangioscopy using SPY DS was feasible and had a marked clinical impact in patients with biliary disease. Additional case reports and prospective studies are needed to examine further applications of this system.
authors.affiliation: Second Department of Internal Medicine, Osaka Medical College Department of Pathology, Osaka Medical College, Osaka Japan.
authors.forename: Miyuki
authors.initials: M
authors.lastname: Imanishi
authors.forename: Takeshi
authors.initials: T
authors.lastname: Ogura
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Kurisu
authors.forename: Saori
authors.initials: S
authors.lastname: Onda
authors.forename: Wataru
authors.initials: W
authors.lastname: Takagi
authors.forename: Atsushi
authors.initials: A
authors.lastname: Okuda
authors.forename: Akira
authors.initials: A
authors.lastname: Miyano
authors.forename: Mio
authors.initials: M
authors.lastname: Amano
authors.forename: Nobu
authors.initials: N
authors.lastname: Nishioka
authors.forename: Daisuke
authors.initials: D
authors.lastname: Masuda
authors.forename: Kazuhide
authors.initials: K
authors.lastname: Higuchi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001649:Bile Duct Diseases / Q000175:diagnosis* / Q000601:surgery*; D001652:Bile Ducts / Q000601:surgery; D001662:Biliary Tract Surgical Procedures / Q000295:instrumentation* / Q000379:methods; D002758:Cholangiography / Q000295:instrumentation* / Q000379:methods; D004867:Equipment Design; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome