Future of Cholangioscopy

Machicado, Jorge D.; Raijman, Isaac

doi:10.1016/j.giec.2022.03.002

Cited by 2 publications

(1 citation statement)

References 40 publications

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“…10 Curative treatment in this clinical situation is surgery, commonly PRSS followed by bilioenteric anastomosis but in this patient, there was no shuntable vein available. [17][18][19]…”

Section: Discussionmentioning

confidence: 99%

Advancements in Cholangioscopy: A Case Report with a New Cholangioscope System and Review of Literature

Lopez,

Ramchandani,

Lakhtakia

et al. 2024

Journal of Digestive Endoscopy

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The field of cholangioscopy is undergoing rapid evolution, marked by continuous innovation. The advent of SpyGlass cholangioscopy has initiated a new chapter, transforming the practice with advancements that include single-operator procedures and the introduction of disposable cholangioscopes. Despite these strides, significant needs remain, including enhancement of optical imaging, improving maneuverability, and expansion of therapeutic channels. This article delves into the recent progress within cholangioscopy, with a particular focus on the clinical applications of the Leinzett Lan-EP-3516 cholangioscope for the management of portal biliopathy. We present a detailed case study demonstrating how this cutting-edge cholangioscope—distinguished by its various sizing options and compatibility with portable devices for immediate imaging—played an important role in the successful treatment of a distal common biliary duct stricture and choledocholithiasis. The device's cost-effectiveness and superior imaging quality signify a notable advancement in cholangioscopic technology, facilitating enhanced treatment pathways for patients with complex biliary disorders. This case exemplifies the dynamic and expanding utility of cholangioscopy in therapeutic interventions and underscores its escalating significance in clinical settings.

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“…10 Curative treatment in this clinical situation is surgery, commonly PRSS followed by bilioenteric anastomosis but in this patient, there was no shuntable vein available. [17][18][19]…”

Section: Discussionmentioning

confidence: 99%

Advancements in Cholangioscopy: A Case Report with a New Cholangioscope System and Review of Literature

Lopez,

Ramchandani,

Lakhtakia

et al. 2024

Journal of Digestive Endoscopy

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Cholangioscopy-based convoluted neuronal network vs. confocal laser endomicroscopy in identification of neoplastic biliary strictures

Robles-Medranda,

Baquerizo-Burgos,

Puga-Tejada

et al. 2024

Endosc Int Open

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Background and study aims Artificial intelligence (AI) models have demonstrated high diagnostic performance identifying neoplasia during digital single-operator cholangioscopy (DSOC). To date, there are no studies directly comparing AI vs. DSOC-guided probe-base confocal laser endomicroscopy (DSOC-pCLE). Thus, we aimed to compare the diagnostic accuracy of a DSOC-based AI model with DSOC-pCLE for identifying neoplasia in patients with indeterminate biliary strictures. Patients and methods This retrospective cohort-based diagnostic accuracy study included patients ≥ 18 years old who underwent DSOC and DSOC-pCLE (June 2014 to May 2022). Four methods were used to diagnose each patient's biliary structure, including DSOC direct visualization, DSOC-pCLE, an offline DSOC-based AI model analysis performed in DSOC recordings, and DSOC/pCLE-guided biopsies. The reference standard for neoplasia was a diagnosis based on further clinical evolution, imaging, or surgical specimen findings during a 12-month follow-up period. Results A total of 90 patients were included in the study. Eighty-six of 90 (95.5%) had neoplastic lesions including cholangiocarcinoma (98.8%) and tubulopapillary adenoma (1.2%). Four cases were inflammatory including two cases with chronic inflammation and two cases of primary sclerosing cholangitis. Compared with DSOC-AI, which obtained an area under the receiver operator curve (AUC) of 0.79, DSOC direct visualization had an AUC of 0.74 (P = 0.763), DSOC-pCLE had an AUC of 0.72 (P = 0.634), and DSOC- and pCLE-guided biopsy had an AUC of 0.83 (P = 0.809). Conclusions The DSOC-AI model demonstrated an offline diagnostic performance similar to that of DSOC-pCLE, DSOC alone, and DSOC/pCLE-guided biopsies. Larger multicenter, prospective, head-to-head trials with a proportional sample among neoplastic and nonneoplastic cases are advisable to confirm the obtained results.

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Future of Cholangioscopy

Cited by 2 publications

References 40 publications

Advancements in Cholangioscopy: A Case Report with a New Cholangioscope System and Review of Literature

Advancements in Cholangioscopy: A Case Report with a New Cholangioscope System and Review of Literature

Cholangioscopy-based convoluted neuronal network vs. confocal laser endomicroscopy in identification of neoplastic biliary strictures

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