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Endoscopy 2015; 47(11): 1054-1056
DOI: 10.1055/s-0034-1392527
Case series
© Georg Thieme Verlag KG Stuttgart · New York

Percutaneous transhepatic cholangioscopy for indeterminate biliary strictures using the SpyGlass system: a case series

Lillian Du
1   Division of Gastroenterology, University of Alberta Hospital, Edmonton, Alberta, Canada
,
Pernilla D’Souza
1   Division of Gastroenterology, University of Alberta Hospital, Edmonton, Alberta, Canada
,
Aducio Thiesen
2   Department of Pathology, University of Alberta Hospital, Edmonton, Alberta, Canada
,
Safwat Girgis
2   Department of Pathology, University of Alberta Hospital, Edmonton, Alberta, Canada
,
Richard Owen
3   Department of Radiology, University of Alberta Hospital, Edmonton, Alberta, Canada
,
Dermot McNally
3   Department of Radiology, University of Alberta Hospital, Edmonton, Alberta, Canada
,
Philippe Sarlieve
3   Department of Radiology, University of Alberta Hospital, Edmonton, Alberta, Canada
,
Gurpal Sandha
1   Division of Gastroenterology, University of Alberta Hospital, Edmonton, Alberta, Canada
› Author Affiliations
Further Information

Publication History

submitted 28 March 2015

accepted after revision 27 May 2015

Publication Date:
13 August 2015 (online)

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Peroral cholangioscopy is useful in differentiating benign from malignant biliary strictures. However, when conventional biliary access via endoscopic retrograde cholangiopancreatography (ERCP) fails, percutaneous transhepatic cholangioscopy (PTCS) via the SpyGlass cholangioscopy system can be used to achieve a diagnosis. Four patients with biliary strictures in whom conventional ERCP was not possible and percutaneous brushings were either nondiagnostic or unsatisfactory were investigated with PTCS. The technique of PTCS involves insertion of the SpyGlass cholangioscope through a percutaneous transhepatic sheath, placed just prior to the procedure, to visualize the stricture and obtain biopsies with the SpyBite forceps. On the basis of our early observations, we conclude that PTCS using the SpyGlass cholangioscopy system for the assessment of biliary strictures is feasible, safe, and provides high diagnostic accuracy.

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  • References

  • 1 Burnett AS, Calvert TJ, Chokshi RJ. Sensitivity of endoscopic retrograde cholangiopancreatography standard cytology: 10-y review of the literature. J Surg Res 2013; 184: 304-311
    CrossrefPubMedGoogle Scholar
  • 2 Fishman DS, Tarnasky PR, Patel SN et al. Management of pancreaticobiliary disease using a new intra-ductal endoscope: the Texas experience. World J Gastroenterol 2009; 15: 1353-1358
    CrossrefPubMedGoogle Scholar
  • 3 Chen YK, Pleskow DK. SpyGlass single-operator peroral cholangiopancreatoscopy system for the diagnosis and therapy of bile-duct disorders: a clinical feasibility study (with video). Gastrointest Endosc 2007; 65: 832-841
    CrossrefPubMedGoogle Scholar
  • 4 de Peralta-Venturina MN, Wong DK, Purslow MJ et al. Biliary tract cytology in specimens obtained by direct cholangiographic procedures: a study of 74 cases. Diagn Cytopathol 1996; 14: 334-348
    CrossrefPubMedGoogle Scholar
  • 5 Jung JY, Lee SK, Oh H-C et al. The role of percutaneous transhepatic cholangioscopy in patients with hilar strictures. Gut Liver 2007; 1: 56-62
    CrossrefPubMedGoogle Scholar
  • 6 Nimura Y, Kamiya J, Hayakawa N et al. Cholangioscopic differentiation of biliary strictures and polyps. Endoscopy 2008; 21 : 351-356
    Article in Thieme ConnectPubMedGoogle Scholar
  • 7 Kim EH, Kim H-J, Oh H-C et al. The usefulness of percutaneous transhepatic cholangioscopy for identifying malignancies in distal common bile duct strictures. J Korean Med Sci 2008; 23: 579-585
    CrossrefPubMedGoogle Scholar
  • 8 Seo DW, Lee SK, Yoo KS et al. Cholangioscopic findings in bile duct tumors. Gastrointest Endosc 2000; 52: 630-634
    CrossrefPubMedGoogle Scholar