Document Detail


Diagnostic and therapeutic utility of SpyGlass® peroral cholangioscopy in intraductal biliary disease: a single-center, retrospective, cohort study.
MedLine Citation:
PMID:  25394296     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVES: SpyGlass® cholangiopancreatoscopy system has shown early success in aiding diagnosis and management of pancreaticobiliary diseases. We aimed to assess the technical success, clinical success, diagnostic yield, therapeutic yield, and safety of SpyGlass® system at a single institution.
METHODS: A retrospective, single-center review of consecutive patients who underwent ERCP with SpyGlass® between 1/2008 and 8/2013 for variety of indications. Technical success was defined as the procedure being completed as planned. Clinical success was defined as a successful outcome as supported via diagnostic, clinical, laboratory, or imaging evidence.
RESULTS: SpyGlass® cholangioscopy was performed in 88 patients (49 female, mean age 56.9 ± 15.5 years). Indications were diagnostic in 67 and therapeutic in 21. Overall, technical success was seen in 87.5% and clinical success in 77.3%. Thirty nine patients with indeterminate biliary stricture had technical and clinical success rates of 92.3% and 74.4%, respectively. In this subgroup malignancy was ultimately diagnosed in 13 with 12 patients diagnosed by SpyGlass® and confirmed by surgical specimens in 12/12 cases (PPV of 100%). In the 23 remaining patients with indeterminate biliary strictures, one was later found to have malignancy (NPV of 95.8%) after 1 year follow-up. In the 13 therapeutic cases of stone removal, technical and clinical success was seen in 77.0% for both. Overall, adverse events were seen in 15.9%.
CONCLUSIONS: SpyGlass® demonstrated acceptable technical and clinical success rates in both diagnostic and therapeutic procedures. In particular, it allows for an accurate rate of diagnosis of indeterminate biliary strictures.
Authors:
Alan H Tieu; Vivek Kumbhari; Neha Jakhete; Frances Onyimba; Yuval Patel; Eun Ji Shin; Zhiping Li
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-11-13
Journal Detail:
Title:  Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society     Volume:  -     ISSN:  1443-1661     ISO Abbreviation:  Dig Endosc     Publication Date:  2014 Nov 
Date Detail:
Created Date:  2014-11-13     Completed Date:  -     Revised Date:  2014-11-14    
Medline Journal Info:
Nlm Unique ID:  9101419     Medline TA:  Dig Endosc     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
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This article is protected by copyright. All rights reserved.
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