Percutaneous transhepatic cholangioscopy using a single-operator cholangioscope (pSOC), a retrospective, observational, multicenter study.


Journal

Surgical endoscopy
ISSN: 1432-2218
Titre abrégé: Surg Endosc
Pays: Germany
ID NLM: 8806653

Informations de publication

Date de publication:
12 2021
Historique:
received: 05 08 2020
accepted: 15 11 2020
pubmed: 6 1 2021
medline: 6 1 2022
entrez: 5 1 2021
Statut: ppublish

Résumé

Percutaneous cholangioscopy (PC) is more complex and invasive than a transpapillary approach, with the need for a large percutaneous tract of 16 French (Fr) on average in order to advance standard percutaneous cholangioscopes. The aim of this study was to investigate whether percutaneous single-operator cholangioscopy (pSOC) using the SpyGlass The data of 28 patients who underwent pSOC in 4 tertiary referral centers were retrospectively analyzed. Technical and clinical success for therapeutic procedures was assessed as well as diagnostic accuracy of pSOC-guided biopsies and visualization. Adverse events and the required number and size of dilatations were reviewed. 25/28 (89%) patients had a post-surgical altered anatomy. The average number of percutaneous dilatations prior to pSOC was 1.25 with a mean dilatation size of 11 French. Histopathology showed a 100% accuracy. Visual impression showed an overall accuracy of 96.4%. Technical and clinical success was achieved in 27/28 (96%) of cases. Adverse events occurred in 3/28 (10.7%) cases. pSOC is a feasible, safe, and effective technique for diagnostic and therapeutic indications. It may be considered an alternative approach in clinical cases where gastrointestinal anatomy is altered. It has the potential to reduce peri-procedural adverse events and costs. Prospective randomized-controlled trials are necessary to confirm the previously collected data.

Sections du résumé

BACKGROUND AND AIMS
Percutaneous cholangioscopy (PC) is more complex and invasive than a transpapillary approach, with the need for a large percutaneous tract of 16 French (Fr) on average in order to advance standard percutaneous cholangioscopes. The aim of this study was to investigate whether percutaneous single-operator cholangioscopy (pSOC) using the SpyGlass
MATERIALS AND METHODS
The data of 28 patients who underwent pSOC in 4 tertiary referral centers were retrospectively analyzed. Technical and clinical success for therapeutic procedures was assessed as well as diagnostic accuracy of pSOC-guided biopsies and visualization. Adverse events and the required number and size of dilatations were reviewed.
RESULTS
25/28 (89%) patients had a post-surgical altered anatomy. The average number of percutaneous dilatations prior to pSOC was 1.25 with a mean dilatation size of 11 French. Histopathology showed a 100% accuracy. Visual impression showed an overall accuracy of 96.4%. Technical and clinical success was achieved in 27/28 (96%) of cases. Adverse events occurred in 3/28 (10.7%) cases.
CONCLUSION
pSOC is a feasible, safe, and effective technique for diagnostic and therapeutic indications. It may be considered an alternative approach in clinical cases where gastrointestinal anatomy is altered. It has the potential to reduce peri-procedural adverse events and costs. Prospective randomized-controlled trials are necessary to confirm the previously collected data.

Identifiants

pubmed: 33398561
doi: 10.1007/s00464-020-08176-1
pii: 10.1007/s00464-020-08176-1
doi:

Types de publication

Journal Article Multicenter Study Observational Study Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

6724-6730

Informations de copyright

© 2021. Springer Science+Business Media, LLC, part of Springer Nature.

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Auteurs

Christian Gerges (C)

Evangelisches Krankenhaus, Düsseldorf, Germany.

Alain García Vázquez (AG)

Institute of Image-Guided Surgery, 1 place de l´Hopital, 67091, Strasbourg, France.
Research Institute against Digestive Cancer, IRCAD, Strasbourg University, Strasbourg, France.

Andrea Tringali (A)

Digestive Endoscopy Unit, Center for Endoscopic Research Therapeutics and Training (CERTT), Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy.
Radiology Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy.

Juan Manuel Verde (JM)

Institute of Image-Guided Surgery, 1 place de l´Hopital, 67091, Strasbourg, France. juan.verde@ihu-strasbourg.eu.
Research Institute against Digestive Cancer, IRCAD, Strasbourg University, Strasbourg, France. juan.verde@ihu-strasbourg.eu.

Tobias Dertmann (T)

Evangelisches Krankenhaus, Düsseldorf, Germany.

Eduardo Houghton (E)

Daicim Foundation, Training, Research, and Clinical activity in Minimally Invasive Surgery, Buenos Aires, Argentina.

Alessandro Cina (A)

Radiology Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy.

Torsten Beyna (T)

Evangelisches Krankenhaus, Düsseldorf, Germany.

Federico Sylvestre Begnis (FS)

Daicim Foundation, Training, Research, and Clinical activity in Minimally Invasive Surgery, Buenos Aires, Argentina.

Margherita Pizzicannella (M)

Institute of Image-Guided Surgery, 1 place de l´Hopital, 67091, Strasbourg, France.
Research Institute against Digestive Cancer, IRCAD, Strasbourg University, Strasbourg, France.

Mariano Palermo (M)

Daicim Foundation, Training, Research, and Clinical activity in Minimally Invasive Surgery, Buenos Aires, Argentina.

Silvana Perretta (S)

Institute of Image-Guided Surgery, 1 place de l´Hopital, 67091, Strasbourg, France.
Research Institute against Digestive Cancer, IRCAD, Strasbourg University, Strasbourg, France.

Guido Costamagna (G)

Digestive Endoscopy Unit, Center for Endoscopic Research Therapeutics and Training (CERTT), Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy.
Radiology Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy.

Jacques Marescaux (J)

Research Institute against Digestive Cancer, IRCAD, Strasbourg University, Strasbourg, France.

Horst Neuhaus (H)

Evangelisches Krankenhaus, Düsseldorf, Germany.

Ivo Boškoski (I)

Digestive Endoscopy Unit, Center for Endoscopic Research Therapeutics and Training (CERTT), Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy.
Radiology Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy.

Mariano Eduardo Giménez (ME)

Institute of Image-Guided Surgery, 1 place de l´Hopital, 67091, Strasbourg, France.
Research Institute against Digestive Cancer, IRCAD, Strasbourg University, Strasbourg, France.
Daicim Foundation, Training, Research, and Clinical activity in Minimally Invasive Surgery, Buenos Aires, Argentina.

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