Open Access
CC BY-NC-ND 4.0 · Endosc Int Open 2020; 08(08): E1091-E1096
DOI: 10.1055/a-1192-4082
Original article

Cholangiopancreatoscopy-guided laser dissection and ablation for pancreas and biliary strictures and neoplasia

Samuel Han
Division of Gastroenterology and Hepatology, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States
,
Raj J. Shah
Division of Gastroenterology and Hepatology, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States
› Institutsangaben
Preview

Abstract

Background and study aims Cholangiopancreatoscopy-guided laser dissection or ablation (CPL) is a novel therapeutic modality for refractory benign strictures. Our aim was to describe the safety and efficacy of CPL for pancreaticobiliary disorders.

Patients and methods Patients who underwent CPL using holmium or thulium laser between February 2017 and September 2019 were included. For stricture dissection, gentle strokes of the laser fiber from a distal to proximal approach were applied until luminal patency permitted advancement of the cholangiopancreatoscope. Immediate technical success was defined as ability to traverse the stricture with the cholangiopancreatoscope after CPL. Short-term technical success was defined as > 90 % resolution of the stricture on follow-up pancreatogram.

Results Eleven patients underwent a mean of 3.6 ERCPs (mean total diameter of 14.2 Fr of stenting) prior to CPL. Indications included pancreatic duct stricture (n = 8), pancreaticojejunostomy anastomotic stricture (n = 1), bile duct stricture (n = 1) and pancreatic intraductal papillary mucinous neoplasm ablation (n = 1). Immediate technical success was 94.1 % and short-term technical success rates was 88.2 %. At a mean follow-up of 12.1 months, there have been no stricture recurrences.

Conclusions CPL may be an effective therapy for strictures refractory to conventional dilation and multiple stenting.



Publikationsverlauf

Eingereicht: 28. Februar 2020

Angenommen: 08. Mai 2020

Artikel online veröffentlicht:
21. Juli 2020

© 2020. Owner and Copyright ©

© Georg Thieme Verlag KG
Stuttgart · New York