Project description:Background and aimsThe single-operator digital cholangioscope has allowed visual access to the biliary tree and the ability to perform selective biopsies. This has significantly improved our diagnostic yield in bile-duct disorders. Cholangioscopy requires specialized equipment and expertise. It is especially challenging in altered anatomy for various reasons, including difficulty in accessing the biliary tree, difficulty in maintaining endoscope position, and difficulty in using ERCP specialized tools. In addition, the use of cholangioscopy in interventional procedures has been very limited. In this video, we demonstrate some of the diagnostic and therapeutic uses of percutaneous cholangioscopy in patients with altered anatomy of the biliary tree.MethodsPercutaneous cholangioscopy was performed in 3 different procedures in 2 patients with altered anatomy of the biliary tree. The first was for the diagnosis of a distally located malignant biliary stricture, the second was for management of hemobilia, and the third was for biliary stent placement.ResultsTechnical and clinical success was achieved in all 3 situations. There were no procedure-related adverse events.ConclusionThe use of percutaneous cholangioscopy in altered anatomy for diagnostic and therapeutic uses is safe and effective and may prove very useful in selected unusual conditions.

| S-EPMC6730491 | biostudies-literature

Peroral-cholangioscopy to plan surgery for protruding biliary lesions: report of four cases.

Project description:Intraductal biliary lesions can involve the main hepatic confluence. Assessment of the extension of pedunculated biliary lesions during per-oral cholangioscopy (POCS) can optimize and personalize the surgical strategy. Four consecutive cases of pedunculated biliary lesions were analysed. Cholangioscopy was performed with a disposable single-operator cholangioscope. POSC was successfully performed in four patients (three female, mean age 50 years), showing involvement of the main biliary confluence in three of four pedunculated biliary lesions; direct biopsy sampling was diagnostic in two of three cases (in one patient, biopsy were not performed due to the smooth appearance of the intrabiliary lesion). No adverse events occurred after POCS. Surgery required excision of the main hepatic confluence in two of three cases (one patient was not resectable). POCS can diagnose intrabiliary extension of protruding biliary lesions, providing important information to plan the surgical intervention.

| S-EPMC9709184 | biostudies-literature

Snare-tip-assisted peroral endoscopic myotomy for achalasia (with video).

Project description: Not available

| S-EPMC7434591 | biostudies-literature

Peroral endoscopic myotomy using an endoscopic dissector: another novel device in our toolbox.

Project description:Video 1Peroral endoscopic myotomy using an endoscopic dissector for achalasia.

| S-EPMC9832240 | biostudies-literature

Efficacy and Safety of Complete Endoscopic Resection of Colorectal Neoplasia Using a Stepwise Endoscopic Protocol with SOUTEN, a Novel Multifunctional Snare.

Project description:BACKGROUND/AIMS:A multifunctional snare SOUTEN has a sharp tip at the top of the snare loop that enables incision of the mucosa, dissection of the submucosal layer, and snaring of lesion. This study assessed the efficacy and safety of complete endoscopic resection of colorectal neoplasia using SOUTEN. METHODS:We analyzed the rates of gross en bloc resection and complete resections of 108 consecutive tumors from 69 patients resected by precutting endoscopic mucosal resection (precutting), hybrid endoscopic submucosal dissection (hybrid), or conventional endoscopic submucosal dissection (conventional) using SOUTEN. RESULTS:Out of the 108 tumors, 50 were resected by precutting, 27 were resected by hybrid after attempting precutting, and the remaining 31 were resected by conventional after attempting precutting and hybrid resections. The median tumor sizes were 14.5 mm for precutting, 16.4 mm for hybrid, and 21.1 mm for conventional. The success rate of gross en bloc resection and histological complete resection were 100% and 94.0% for precutting, 96.4% and 96.4% for hybrid, and 100% and 100% for conventional method, respectively. No procedure-related complication occurred. CONCLUSION:By using SOUTEN, precutting and hybrid were successfully performed on 10-30 mm tumors with a shorter procedure time than conventional without major complications.

| S-EPMC7137565 | biostudies-literature

Case report: Single-operator peroral cholangioscopy system (SpyGlass) diagnosis of an extrahepatic biliary cystadenoma (video).

Project description:Biliary cystadenoma is a type of rare liver cystic tumor. Intrahepatic biliary cystadenomas are the most common, while extrahepatic biliary cystadenomas are rarely seen. Biliary cystadenoma tends to occur in middle-aged to older women and there is a lack of specific preoperative diagnostic markers. Recent advancements in technology and the development of the SpyGlass system have led to an increased use of cholangioscopy. Herein, we report a patient in whom a space-occupying lesion was found in the bile duct by SpyGlass, and who later underwent radical surgery. The pathology report indicated that the final diagnosis was biliary cystadenoma. SpyGlass cholangioscopy may be a novel and effective diagnostic method for biliary cystadenoma.

| S-EPMC10327893 | biostudies-literature

The new criteria for differential diagnosis of indeterminate biliary stricture under super minimally invasive peroral cholangioscopy.

Project description: Not available

| S-EPMC10836894 | biostudies-literature