The Usefulness of Peroral Cholangioscopy for Intrahepatic Stones

Sakamoto, Yuri; Takeda, Yohei; Sasaki, Yuta; Kawahara, Shiho; Shimosaka, Takuya; Hamamoto, Wataru; Koda, Hiroki; Yamashita, Taro; Onoyama, Takumi; Matsumoto, Kazuya; Yashima, Kazuo; Isomoto, Hajime

doi:10.3390/jcm11216425

Cited by 3 publications

(1 citation statement)

References 14 publications

(16 reference statements)

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“…even if biliary access can be achieved via endoscopic retrograde cholangiopancreatography (ERCP). ERCP, especially since the introduction of single operator cholangioscopy (SOC) into clinical practice, allows directly guided diagnostic and therapeutic manipulations in the biliary tree, increasing the successful cannulation of intrahepatic ducts [1][2][3][4]. Nevertheless, access to the intrahepatic ducts, especially when affected by strictures or stones, can be difficult.…”

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confidence: 99%

Performance and safety of percutaneous cholangioscopy: a systematic review and meta-analysis

Papaefthymiou,

Gkolfakis,

Basiliya

et al. 2023

ESGE Days 2023

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Background Percutaneous cholangioscopy (PerC) offers an alternative for patients with an inaccessible biliary tree. This systematic review and meta-analysis aimed to evaluate the performance of this technique.Methods A search in Medline, Cochrane and ClinicalTrials.gov databases was performed for studies assessing PerC up to October 2022. The primary outcome was diagnostic success, defined as successful stone identification or stricture workup. Secondary outcomes included therapeutic success (stone extraction, stenting) and complication rate. A subgroup analysis compared previous-generation and modern cholangioscopes. We performed meta-analyses using a randomeffects model and the results were reported as percentages with 95% confidence interval (CI).Results Fourteen studies (682 patients) were eligible for analysis. The rate of diagnostic success was 98.7% (95%CI 97.6-99.8%; I 2 =31.19%) and therapeutic success was 88.6% (95%CI 82.8-94.3%; I 2 =74.92%). Adverse events were recorded in 17.1% (95%CI 10.7-23.5%; I 2 =77.56%), of which 15.9% (95%CI 9.8-21.9%; I 2 =75.98%) were minor and 0.6% (95%CI 0.1-1.2%; I 2 =0%) major. The Spyglass system showed null heterogeneity for all outcomes; compared with older-generation endoscopes it offered comparable diagnostic success, but yielded significantly superior therapeutic success (96.1%, 95%CI 90-100%; I 2 =0% vs. 86.4%, 95%CI 79.2-93.6%; I 2 =81.41%; P=0.02]. ConclusionPerC, especially using currently available cholangioscopes, is associated with high diagnostic and therapeutic success.

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mentioning

confidence: 99%

Performance and safety of percutaneous cholangioscopy: a systematic review and meta-analysis

Papaefthymiou,

Gkolfakis,

Basiliya

et al. 2023

ESGE Days 2023

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Digital cholangioscopy-assisted, direct visualization-guided, radiation-free, endoscopic retrograde intervention for cholelithiasis: technical feasibility, efficacy, and safety

Feng,

Liang,

Liu

et al. 2024

Surg Endosc

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Comparative Study of Endoscopic Treatment for Intrahepatic and Common Bile Duct Stones Using Peroral Cholangioscopy

Sakamoto,

Takeda,

Yamashita

et al. 2024

JCM

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Objectives: Although peroral cholangioscopy has improved the endoscopic treatment of difficult stones, the treatment of intrahepatic stones remains challenging. The incidence of cholangitis is high when peroral cholangioscopy is used to treat intrahepatic stones. This study aimed to investigate the efficacy and safety of endoscopic treatment with peroral cholangioscopy for intrahepatic and common bile duct stones. Methods: Patients aged ≥20 years, who underwent endoscopic treatment with peroral cholangioscopy for intrahepatic or common bile duct stones at Tottori University Hospital from January 2016 to December 2022, were retrospectively evaluated to determine the efficacy and safety of the treatment. Results: Overall, 70 patients were included in this study: 22 in the intrahepatic stone group and 48 in the common bile duct stone group. Stones were smaller (8 vs. 17.5 mm, p < 0.001) and more numerous (p = 0.016) in the intrahepatic stone group than in the common bile duct stone group. Although the common bile duct stone group exhibited a higher rate of complete stone clearance in the first session, no significant differences were observed in the final results. The intrahepatic stone group had a higher incidence of cholangitis (36% vs. 8%, p = 0.007); however, all cases were mild. Conclusions: Endoscopic treatment with peroral cholangioscopy for intrahepatic stones may be associated with a higher incidence of cholangitis than that for common bile duct stones. Since saline irrigation may contribute to the development of cholangitis, it is important to be aware of intraductal bile duct pressure when performing peroral cholangioscopy.

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The Usefulness of Peroral Cholangioscopy for Intrahepatic Stones

Cited by 3 publications

References 14 publications

Performance and safety of percutaneous cholangioscopy: a systematic review and meta-analysis

Performance and safety of percutaneous cholangioscopy: a systematic review and meta-analysis

Digital cholangioscopy-assisted, direct visualization-guided, radiation-free, endoscopic retrograde intervention for cholelithiasis: technical feasibility, efficacy, and safety

Comparative Study of Endoscopic Treatment for Intrahepatic and Common Bile Duct Stones Using Peroral Cholangioscopy

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