Role of SpyGlass Peroral Cholangioscopy in the Evaluation of Indeterminate Biliary Lesions

Woo, Youngmin; Lee, Jong Kyun; Oh, Se Hun; Kim, Min Jung; Jung, Jae Gu; Lee, Kwang Hyuck; Lee, Kyu Taek

doi:10.1007/s10620-014-3171-x

Cited by 64 publications

(57 citation statements)

References 23 publications

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“…The diagnostic yield of TB under SOCS in the current study was comparable to that reported by previous studies [11][12][13][14][15][16][17][18][19]. Many of the previous reports noted that more than three tissue samples were required for an accurate diagnosis, as the relatively small tissue samples obtained by SpyBite  rendered pathological examination challenging.…”

Section: Discussionsupporting

confidence: 87%

“…The SpyGlass  system by Boston Scientific is a recently launched single-operator cholangioscopy (SOCS) [10]. The sensitivity, specificity, and accuracy of targeted biopsy (TB) of biliary strictures using SpyGlass  were reported as 49-88%, 82-100%, and 25-88%, respectively [11][12][13][14][15][16][17][18][19]. However, a meta-analysis showed that the sensitivity of the SpyGlass  system was only moderate; thus, its diagnostic value requires improvement [20].…”

Section: Introductionmentioning

confidence: 99%

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Utility of lavage cytology plus targeted biopsy during cholangioscopy for the diagnosis of indeterminate biliary lesions

Motomura¹,

Akahoshi²,

Kawakami³

et al. 2017

Gastroenterol Hepatol Endosc

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Section: Discussionsupporting

confidence: 87%

Section: Introductionmentioning

confidence: 99%

Utility of lavage cytology plus targeted biopsy during cholangioscopy for the diagnosis of indeterminate biliary lesions

Motomura¹,

Akahoshi²,

Kawakami³

et al. 2017

Gastroenterol Hepatol Endosc

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“…In fact, the cholangiopancreatoscopy with SpyGlass® has demonstrated promising results in an international multicenter study [3], and was approved by the US Food and Drug Administration in 2009 for diagnostic and therapeutic applications during endoscopic procedures in the pancreatobiliary system [4].…”

Section: Introductionmentioning

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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“…23 Many studies have reported the characteristics of SOC, although they are mostly observational in nature and performed using the first generation SpyGlass device (Table 2). 3,[24][25][26][27][28][29][30][31][32] The largest study was a 2011 prospective cohort study including 15 referral centers in the United States and Europe. This study included 297 patients, with 226 who underwent SOC for diagnosis of suspected bile duct disease and 95 who received biopsies for sensitivity and specificity analysis.…”

Section: Single-operator Cholangioscopymentioning

confidence: 99%

The role and utility of cholangioscopy for diagnosing indeterminate biliary strictures

Thaker

Muthusamy

2017

Int J Gastrointest Interv

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Biliary strictures are considered indeterminate when evaluation with imaging and standard tissue sampling during endoscopic retrograde cholangiopancreatography (ERCP) are non-diagnostic. Standard tissue sampling techniques include cytologic brushings, with or without fluorescence in situ hybridization (FISH), and endoscopic intraductal biopsies. These strictures are often clinically suspicious for malignancy. The management of these patients can vary substantially and relies on an accurate diagnosis of the lesion. Unfortunately, despite numerous modalities, the sensitivity of existing tissue sampling techniques remains low and can lead to delays in diagnosis and the need for additional procedures. Cholangioscopy has emerged as a means to visually inspect and obtain image-guided biopsies of the lesion in question, with improved sensitivity as well as a high specificity and accuracy for diagnosing the etiology of indeterminate biliary strictures. The types of cholangioscopy systems and a summary of the pertinent literature are discussed in this review.

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Role of SpyGlass Peroral Cholangioscopy in the Evaluation of Indeterminate Biliary Lesions

Cited by 64 publications

References 23 publications

Utility of lavage cytology plus targeted biopsy during cholangioscopy for the diagnosis of indeterminate biliary lesions

Utility of lavage cytology plus targeted biopsy during cholangioscopy for the diagnosis of indeterminate biliary lesions

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

The role and utility of cholangioscopy for diagnosing indeterminate biliary strictures

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