scholarly journals Sa1300 PERORAL CHOLANGIOSCOPY BY SPYGLASS DS VERSUS CHF-B260 FOR EVALUATION OF THE LATERAL SPREAD OF EXTRAHEPATIC CHOLANGIOCARCINOMA

2018 ◽  
Vol 87 (6) ◽  
pp. AB202-AB203
Author(s):  
Yoshihide Kanno ◽  
Takahisa Ogawa ◽  
Shinsuke Koshita ◽  
Kaori Masu ◽  
Hiroaki Kusunose ◽  
...  
Keyword(s):  
Lateral Spread ◽  
Extrahepatic Cholangiocarcinoma ◽  
Peroral Cholangioscopy ◽  
Spyglass Ds

scholarly journals Peroral cholangioscopy by SpyGlass DS versus CHF-B260 for evaluation of the lateral spread of extrahepatic cholangiocarcinoma

2018 ◽  
Vol 06 (11) ◽  
pp. E1349-E1354 ◽  
Author(s):  
Yoshihide Kanno ◽  
Shinsuke Koshita ◽  
Takahisa Ogawa ◽  
Kaori Masu ◽  
Hiroaki Kusunose ◽  
...  
Keyword(s):  
Outcome Measure ◽  
Lateral Spread ◽  
Extrahepatic Cholangiocarcinoma ◽  
Peroral Cholangioscopy ◽  
Guided Biopsy ◽  
Group A ◽  
Lateral Extent ◽  
Group B ◽  
Spyglass Ds ◽  
Mapping Biopsy

Abstract Background and study aims A newly developed peroral cholangioscopy (POCS) system, SpyGlassDS has high maneuverability. This study aimed to evaluate acceptability of the accuracy of SpyGlassDS accompanied by simultaneous POCS-guided biopsy compared with that of a traditional POCS scope, CHF-B260, to diagnose the lateral extent of extrahepatic cholangiocarcinoma (LEC). Patients and methods Patients who underwent surgical resection after preoperative examinations to diagnose LEC were evaluated. POCS by CHF-B260 was performed if there was discrepancy between preceding fluoroscopy-guided biopsy findings and other examinations between January 2004 and September 2015 (group A, n = 56); and POCS plus POCS-guided mapping biopsy by SpyGlassDS was performed in all surgical candidates between October 2015 and December 2017 (group B, n = 20). The main outcome measure was the accuracy of overall preoperative diagnosis (OPD) of LEC defined based on all examinations, including POCS. Results Accuracy of OPD for the liver side and the ampullary side was 93 % and 100 %, respectively, in group A, and 84 % and 100 %, respectively, in group B (P = 0.37 for the liver side; P, not available for the ampullary side). Diagnostic accuracy of simple optical evaluation by POCS for the liver side and the ampullary side was 83 % and 100 %, respectively, in group A, and 58 % and 88 %, respectively, in group B (P = 0.29 for the liver side; P = 0.40 for the ampullary side). Conclusions POCS by SpyGlassDS was found to be acceptable and could be a standard approach for diagnosis of LEC.

scholarly journals Usefulness of cholangioscopic-guided mapping biopsy using SpyGlass DS for preoperative evaluation of extrahepatic cholangiocarcinoma: a pilot study

2018 ◽  
Vol 06 (02) ◽  
pp. E199-E204 ◽  
Author(s):  
Takahisa Ogawa ◽  
Kei Ito ◽  
Shinsuke Koshita ◽  
Yoshihide Kanno ◽  
Kaori Masu ◽  
...  
Keyword(s):  
Bile Duct ◽  
Diagnostic Accuracy ◽  
Bile Duct Carcinoma ◽  
Preoperative Evaluation ◽  
Extrahepatic Cholangiocarcinoma ◽  
Duct Carcinoma ◽  
The Right ◽  
Spyglass Ds ◽  
Tumor Extent ◽  
Mapping Biopsy

Abstract Background and study aims Evaluation of longitudinal tumor extent is indispensable for curative surgical treatment of extrahepatic cholangiocarcinoma. The aim of this study was to evaluate the usefulness and feasibility of cholangioscopic-guided mapping biopsy using a newly developed peroral digital cholangioscope, SpyGlass DS (SpyDS), for preoperative evaluation of extrahepatic cholangiocarcinoma. Patients and methods Thirteen patients (mean age, 75 years; male 10, female 3) with extrahepatic cholangiocarcinoma who underwent cholangioscopic-guided mapping biopsy using SpyDS for preoperative evaluation were included in this study. Successful cholangioscopic-guided mapping biopsy was defined as the acquisition of specimens sufficient for histopathological diagnosis. Results The mean number of biopsies was 5 per patient. The overall success rate for cholangioscopic-guided mapping biopsy was 88 % (59/67). The success rate for cholangioscopic-guided mapping biopsy from the confluence of the right and left hepatic ducts was 89 %, that from the B4 confluence was 93 %, that from the confluence of the right anterior and right posterior segmental ducts was 86 %, that from the intrapancreatic common bile duct was 67 %, and that from the main lesion was 100 %. The overall diagnostic accuracy of longitudinal tumor extent at the hepatic side, the duodenal side and overall by cholangioscopic findings and mapping biopsy, was 88 % (7/8), 88 % (7/8) and 88 % (7/8), respectively. Assessment according to location of the main lesion revealed that diagnostic accuracy in the patients with distal bile duct carcinoma was 100 % (5/5) and that in patients with perihilar bile duct carcinoma was 66 % (2/3). Complications after the procedure did not occur in any patients. Conclusions Cholangioscopic-guided mapping biopsy using SpyDS is thought to be feasible for preoperative evaluation of extrahepatic cholangiocarcinoma.

scholarly journals Peroral Cholangioscopy-Guided Forceps Biopsy and Endoscopic Scraper for the Diagnosis of Indeterminate Extrahepatic Biliary Stricture

2019 ◽  
Vol 8 (6) ◽  
pp. 873 ◽  
Author(s):  
Masayuki Kato ◽  
Takumi Onoyama ◽  
Yohei Takeda ◽  
Soichiro Kawata ◽  
Hiroki Kurumi ◽  
...  
Keyword(s):  
Adverse Events ◽  
Sphincter Of Oddi ◽  
Diagnostic Utility ◽  
Biliary Disease ◽  
Extrahepatic Cholangiocarcinoma ◽  
Forceps Biopsy ◽  
Peroral Cholangioscopy ◽  
Pathological Evaluation ◽  
Tissue Acquisition ◽  
Sensitivity Specificity

Background: Peroral cholangioscopy (POCS) has become a widely-used technique in diagnosing indeterminate biliary strictures, enabling optical viewing of the biliary system and targeted biopsies under direct vision. The diagnostic utility of the new endoscopic scraper, Trefle®, for extrahepatic cholangiocarcinoma (ECC) has also been reported. However, the diagnostic utility of POCS-guided and Trefle®-assisted tissue acquisition for ECC has never been compared empirically. We evaluated the efficacy and safety of Trefle®-assisted tissue acquisition for diagnosing ECC compared with POCS-guided tissue sampling. Methods: Patients who underwent Trefle®-assisted tissue acquisition or POCS-guided forceps biopsy to differentiate ECC from benign biliary disease between April 2014 and March 2018 were enrolled retrospectively. We evaluated the diagnostic performance of Trefle®-assisted tissue acquisition and POCS-guided forceps biopsy based on pathological evaluation. We also compared adverse events associated with Trefle®-assisted tissue acquisition with those of POCS-guided forceps biopsy. Results: We enrolled 34 patients with biliary disease and performed Trefle®-assisted tissue acquisition and POCS-guided forceps biopsy in 14 and 20 patients, respectively. Sensitivity, specificity, and accuracy of Trefle®-assisted tissue acquisition were 87.5%, 83.3%, and 85.7%, respectively, and for POCS-guided forceps biopsy, these were 90.0% each. Statistical values of Trefle®-assisted tissue acquisition and POCS-guided tissue acquisition were not significantly different. There were no significant differences in the occurrence of adverse events between the Trefle®-assisted tissue acquisition and the POCS-guided forceps biopsy (35.7% vs. 25.0%, p = 0.770). Compared with patients who underwent POCS procedure, endoscopic sphincterotomy was performed for fewer patients who underwent Trefle®-assisted tissue acquisition (p < 0.001). Conclusions: The diagnostic ability of Trefle®-assisted tissue acquisition for ECC is similar to that of POCS-guided tissue acquisition. Trefle®-assisted tissue acquisition might also help to preserve the sphincter of Oddi and its digestive function.

scholarly journals Peroral Cholangioscopy-guided Electrohydraulic Lithotripsy with a SpyGlass DS Versus a Conventional Digital Cholangioscope for Difficult Bile Duct Stones

2020 ◽  
Vol 59 (16) ◽  
pp. 1925-1930
Author(s):  
Toji Murabayashi ◽  
Takahisa Ogawa ◽  
Shinsuke Koshita ◽  
Yoshihide Kanno ◽  
Hiroaki Kusunose ◽  
...  
Keyword(s):  
Bile Duct ◽  
Bile Duct Stones ◽  
Peroral Cholangioscopy ◽  
Electrohydraulic Lithotripsy ◽  
Spyglass Ds

Sa1436 PERORAL CHOLANGIOSCOPY-GUIDED LITHOTRIPSY WITH A SPYGLASS DS VERSUS A CONVENTIONAL CHOLANGIOSCOPE FOR DIFFICULT BILE DUCT STONES

2019 ◽  
Vol 89 (6) ◽  
pp. AB229-AB230
Author(s):  
Toji Murabayashi ◽  
Takahisa Ogawa ◽  
Shinsuke Koshita ◽  
Yoshihide Kanno ◽  
Kaori Masu ◽  
...  
Keyword(s):  
Bile Duct ◽  
Bile Duct Stones ◽  
Peroral Cholangioscopy ◽  
Spyglass Ds

scholarly journals Efficacy and safety of novel digital single-operator peroral cholangioscopy-guided laser lithotripsy for complicated biliary stones

2017 ◽  
Vol 05 (01) ◽  
pp. E54-E58 ◽  
Author(s):  
John Wong ◽  
Raymond Tang ◽  
Anthony Teoh ◽  
Joseph Sung ◽  
James Lau
Keyword(s):  
Clearance Rate ◽  
Laser Lithotripsy ◽  
Efficacy And Safety ◽  
Biliary Stones ◽  
Distal Common Bile Duct ◽  
Stone Clearance ◽  
Biliary Stone ◽  
Peroral Cholangioscopy ◽  
Single Operator ◽  
Spyglass Ds

Abstract Background/study aims Laser lithotripsy can effectively fragment complicated biliary stones, but current cholangioscopes are limited by fragility, restricted mobility or moderate visual resolution. The efficacy and safety of a new digital single-operator peroral cholangioscope to guide laser lithotripsy were evaluated. Patients and methods In this prospective single-center series, consecutive patients with complicated biliary stones, defined as impacted stones > 1.5 cm in size and wider than the more distal common bile duct, or stones that failed extraction by basket mechanical lithotripsy, underwent ERCP and SpyGlass DS peroral cholangioscope (Boston Scientific, Marlborough, United States)-guided laser lithotripsy. Stone clearance rate and incidence of adverse events were determined. Results Seventeen patients (10 men, 7 women; median age 76 years) with a median biliary stone size of 2 cm underwent predominantly holmium:yttrium aluminum garnet laser lithotripsy, achieving a 94 % stone clearance rate over 1 median procedure. Lithotripsy was performed in 8 of 17 patients due to an impacted biliary stone. The remaining patients underwent lithotripsy due to prior failure of the basket mechanical lithotripter to capture or crush their stones. Post lithotripsy, 2 patients developed cholangitis and 1 patient with underlying COPD developed respiratory distress, all resolved with conservative management. There were no hemobilia, perforations, pancreatitis nor any deaths. Conclusion SpyGlass DS peroral cholangioscopy-guided laser lithotripsy is an efficient and safe modality for management of complicated biliary stones.

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