The Successful Treatment of Chronic Cholecystitis with SpyGlass Cholangioscopy-Assisted Gallbladder Drainage and Irrigation through Self- Expandable Metal Stents

Gutkin, Ellen; Hussain, Syed A.; Kim, Sang Ho

doi:10.5009/gnl.2012.6.1.136

Cited by 11 publications

(10 citation statements)

References 4 publications

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“…As an emerging solution, a handful of case reports have shown the usefulness of cholangioscopy-assisted technique, [17][18][19][20] but no study performed a statistical analysis to investigate it. As shown in Fig.…”

Section: Discussionmentioning

confidence: 99%

“…Few case reports have demonstrated that cholangioscopic assistance is both feasible and effective for GB drainage. [17][18][19][20] In 2006, a single-operator peroral cholangioscopy (SpyGlass; Boston Scientific, Natick, MA, USA) was developed to improve the conventional cholangioscope model, such as increased irrigation flow rate, improved steering, and the capability to perform targeted biopsies under direct visualization. [21][22][23] The latest digital version of single-operator peroral cholangioscopy, SpyGlass DS (SG), is currently available to offer additional advantages including sharper image quality and an easier setup process, allowing for both diagnostic and therapeutic benefits.…”

Section: Introductionmentioning

confidence: 99%

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Four-Step Classification of Endoscopic Transpapillary Gallbladder Drainage and the Practical Efficacy of Cholangioscopic Assistance

et al. 2021

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Background/Aims: Although endoscopic transpapillary gallbladder drainage (ETGBD) has been reported as an alternative procedure for acute cholecystitis, it requires advanced endoscopic techniques. In terms of the certainty of achieving drainage, it remains a challenging procedure. The aim of the current study was to elucidate the practical efficacy of cholangioscopic assistance and to develop a new classification that could be used to evaluate the technical difficulty of ETG-BD and provide a theoretical strategy to apply cholangioscopy appropriately for difficult ETGBD.Methods: A total of 101 patients undergoing ETGBD were retrospectively studied. The characteristics and technical outcomes of ETGBD with conventional ETGBD (C-ETGBD) and Spy-Glass DS-assisted ETGBD (SG-ETGBD) were evaluated. The characteristics and technique-dependent factors of unsuccessful C-ETGBD/SG-ETGBD were evaluated using the classification based on the steps of the procedure. The predictive factors of successful C-ETGBD/SG-ETGBD were examined.Results: C-ETGBD was successful in 73 patients (72.3%). SG-ETGBD was successful in 11 of 13 patients (84.6%) who had C-ETGBD failure. Optional SG-ETGBD significantly increased the final success rate (94.1%) compared to C-ETGBD alone (p=0.003). ETGBD procedures could be classified into four steps. SG-assistance worked as an excellent troubleshooter in step 1 (failure to identify the cystic duct orifice) and step 2 (failure of guidewire advancement across the downturned angle of cystic duct takeoff). Magnetic resonance cholangiopancreatography could provide predictive information based on the classification. Conclusions:Optional SG-ETGBD achieved a significantly higher success rate than C-ETGBD alone.Step classification is helpful for determining the technical difficulty of ETGBD and developing a theoretical strategy to apply cholangioscopy in a coordinated manner.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Four-Step Classification of Endoscopic Transpapillary Gallbladder Drainage and the Practical Efficacy of Cholangioscopic Assistance

et al. 2021

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“…There are some reports on selective cystic duct cannulation, with effective gallbladder drainage in patients diagnosed with severe cholecystitis and unfit for surgery[34,35]. Haemobilia could also be diagnosed and managed successfully by per-oral cholangioscopy[36].…”

Section: Other Clinical Applicationsmentioning

confidence: 99%

Role of digital single-operator cholangioscopy in the diagnosis and treatment of biliary disorders

Karagyozov¹,

Boeva²,

Tishkov³

2019

WJGE

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Due to the need for improvement in the diagnosis and minimally invasive therapy of the bile duct disorders new technologies for cholangioscopy have been recently developed. Per-oral cholangioscopy has become an important diagnostic and therapeutic tool leading to avoidance of aggressive and unnecessary surgery in many clinical scenarios. This paper focuses on the newly developed SpyGlass DS technology, its advantages, and the technique of single-operator cholangioscopy (SOC), biliary indications and possible adverse events. We also review the available literature; discuss the limitations and future expectations. Digital SOC (D-SOC) is a useful technique, which provides endoscopic imaging of the biliary tree, optical diagnosis, biopsy under direct vision and therapeutic interventions. The implementations are diagnostic and therapeutic. Diagnostic indications are indeterminate biliary strictures, unclear filling defects, staging of cholangiocarcinoma, staging of ampullary tumors (extension into the common bile duct), unclear bile duct dilation, exploring cystic lesions of the biliary tree, unexplained hemobilia, posttransplant biliary complications. Therapeutic indications are lithotripsy of difficult stones, retrieval of migrated stents, foreign body removal, guide wire placement, transpapillary gallbladder drainage and endoscopic tumor ablative therapy. Most studied and established indications are the diagnosis of indeterminate biliary stricture and intraductal lithotripsy of difficult stones. The adverse events are not different and more common compared to those of Endoscopic retrograde cholangiopancreatography (ERCP) alone. D-SOC is a safe and effective procedure, adjunct to the standard ERCP and the newly available digital technology overcomes many of the limitations of the previous generations of cholangioscopes.

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“…Cholangioscopy allows endoscopists unparalleled access to the biliary ductal system and as a result different novel uses of this technology other than those described above have been reported in the literature ( Table 1). This includes retrieval of migrated biliary stents (62,63), guidewire placement (64), gallbladder drainage via the cystic duct in selected cases of cholecystitis (65,66), evaluation of post liver transplant biliary strictures (67), evaluation and treatment of hemobilia (68) and even for access of difficult luminal GI strictures (69).…”

Section: Other Clinical Applicationsmentioning

confidence: 99%

Cholangioscopy in the digital era

Ayoub¹,

Yang²,

Draganov³

2018

Transl. Gastroenterol. Hepatol

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Cholangioscopy allows direct visualization and subsequent therapeutic maneuvers of the biliary ductal system. With advances in endoscopic and imaging technology, cholangioscopy has become an important modality for the diagnosis of indeterminate biliary strictures and an essential therapeutic tool for difficult to remove biliary stones. Enhanced imaging and operability of the latest generation cholangioscopes have further expanded their clinical applications to include ductal tumor ablation, gallbladder drainage, access to difficult to reach branches of the biliary tree, and biliary foreign body manipulation. In this review, we discuss the technical evolution of cholangioscopy into the digital era and review the clinical evidence supporting its use in the diagnosis and therapy of biliary tract disease.

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The Successful Treatment of Chronic Cholecystitis with SpyGlass Cholangioscopy-Assisted Gallbladder Drainage and Irrigation through Self- Expandable Metal Stents

Cited by 11 publications

References 4 publications

Four-Step Classification of Endoscopic Transpapillary Gallbladder Drainage and the Practical Efficacy of Cholangioscopic Assistance

Four-Step Classification of Endoscopic Transpapillary Gallbladder Drainage and the Practical Efficacy of Cholangioscopic Assistance

Role of digital single-operator cholangioscopy in the diagnosis and treatment of biliary disorders

Cholangioscopy in the digital era

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