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Percutaneous transcystic cholangioscopy-assisted rendezvous ERCP in a hostile abdomen.

ABSTRACT: Video 1Percutaneous transcystic cholangioscopy-assisted rendezvous ERCP in a hostile abdomen.

SUBMITTER: Zhang LY

PROVIDER: S-EPMC8117940 | biostudies-literature | 2021 May

REPOSITORIES: biostudies-literature

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Percutaneous transcystic cholangioscopy-assisted rendezvous ERCP in a hostile abdomen.

Zhang Linda Y LY Runge Thomas M TM Ichkhanian Yervant Y Kumbhari Vivek V Khashab Mouen A MA

VideoGIE : an official video journal of the American Society for Gastrointestinal Endoscopy 20210311 5

Video 1Percutaneous transcystic cholangioscopy-assisted rendezvous ERCP in a hostile abdomen. ...[more]

PMID: 34027251

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Type VI choledochal cyst diagnosed on ERCP with direct cholangioscopy.

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A comparison between endoscopic ultrasound-guided rendezvous and percutaneous biliary drainage after failed ERCP for malignant distal biliary obstruction.

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EUS-directed transenteric ERCP–assisted internalization of a percutaneous biliary drain in Roux-en-Y anatomy

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Single-port extra-peritoneal robotic radical prostatectomy in a patient with hostile abdomen.

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Endoscopic approach for management of dropped gallstones using percutaneous cholangioscopy

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Digital cholangioscopy can detect residual biliary stones missed by occlusion cholangiogram in ERCP: a prospective tandem study.

Project description:Background and study aims After stone removal in endoscopic retrograde cholangiopancreatography (ERCP), an occlusion cholangiogram (OC) is performed to confirm bile duct clearance. OC can miss residual stones that can lead to recurrent biliary symptoms. The aim of this study was to assess if digital peroral cholangioscopy (POC) increased the diagnostic yield of residual biliary stones that are missed with OC. Patients and methods Patients having ERCP performed for choledocholithiasis were enrolled into the study only if they had one of the following criteria: dilated bile duct ≥ 12 mm and/or if lithotripsy was being performed. An OC was performed to confirm duct clearance after removal of stones followed by POC, based on inclusion criteria. The incremental yield of biliary stones missed by OC but confirmed by POC was then measured. A total of 96 POC procedures were performed on 93 patients in two tertiary care centers. Results Residual biliary stones were found in 34 % of cases. The average bile duct size in cases with residual stones was 15.1 mm ± 0.7 mm. One- to three-mm stones were found in 41 % of cases, 4- to 7-mm stones in 45 % of cases, and ≥ 8-mm stones in 14 % of cases. Lithotripsy was performed in 13 % of cases and was significantly associated with residual stones (30 % vs. 3 %, P < 0.001). Conclusions Occlusion cholangiogram can miss residual stones in patients with dilated bile ducts and those receiving lithotripsy. Digital POC can increase the yield of residual stone detection in these patients and should be considered to confirm clearance of stones. (ClinicalTrials.gov-NCT03482375).

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

Project description:BackgroundPercutaneous 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.MethodsA 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 random-effects model and the results were reported as percentages with 95% confidence interval (CI).ResultsFourteen studies (682 patients) were eligible for analysis. The rate of diagnostic success was 98.7% (95%CI 97.6-99.8%; I2=31.19%) and therapeutic success was 88.6% (95%CI 82.8-94.3%; I2=74.92%). Adverse events were recorded in 17.1% (95%CI 10.7-23.5%; I2=77.56%), of which 15.9% (95%CI 9.8-21.9%; I2=75.98%) were minor and 0.6% (95%CI 0.1-1.2%; I2=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%; I2=0% vs. 86.4%, 95%CI 79.2-93.6%; I2=81.41%; P=0.02].ConclusionPerC, especially using currently available cholangioscopes, is associated with high diagnostic and therapeutic success.

| S-EPMC10927623 | biostudies-literature

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