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Laparoscopic SpyGlass cholangioscopy evaluation during bilioenteric anastomosis for hepatolithiasis, a case report
INTRODUCTION: Careful evaluation of intrahepatic injury of biliary tract diseases is crucial to assure proper management and estimate disease prognosis. Hepatholithiasis is a rare condition that can be associated to cholestatic liver diseases. Additional tools to improve diagnosis and patient care a...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7750126/ https://www.ncbi.nlm.nih.gov/pubmed/33340982 http://dx.doi.org/10.1016/j.ijscr.2020.12.013 |
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author | Figueira, Estela Regina Ramos Franzini, Tomazo Costa, Thiago Nogueira Madruga-Neto, Antonio Coutinho Guedes, Hugo Gonçalo Romano, Vitor Carminatti Ceconello, Ivan de Moura, Eduardo Guimarães Hourneaux |
author_facet | Figueira, Estela Regina Ramos Franzini, Tomazo Costa, Thiago Nogueira Madruga-Neto, Antonio Coutinho Guedes, Hugo Gonçalo Romano, Vitor Carminatti Ceconello, Ivan de Moura, Eduardo Guimarães Hourneaux |
author_sort | Figueira, Estela Regina Ramos |
collection | PubMed |
description | INTRODUCTION: Careful evaluation of intrahepatic injury of biliary tract diseases is crucial to assure proper management and estimate disease prognosis. Hepatholithiasis is a rare condition that can be associated to cholestatic liver diseases. Additional tools to improve diagnosis and patient care are of great interest specially if associated to decreased morbidity. Recently the spread of single-operator platforms of cholangioscopy brought this procedure back to scene. Our aim was to identify safety, feasibility and utility of SpyGlass cholangioscopy of biliary tract during laparoscopic hepaticojejunostomy. PRESENTATION OF CASE: A 53 years-old man with hepatolithiasis associated to choledolithiasis under treatment with ursodeoxycholic acid and fenofibrate for 8 months, was submitted to laparoscopic hepaticojejunostomy with cholangioscopy for biliary duct evaluation. Spyscope was inserted through a right lateral laparoscopic trocar entering the common bile duct. Examination of intra-hepatic bile ducts showed injury of right biliary. Few microcalculi were visualized. Left biliary ducts presented normal mucosa. Histopathological examination showed a chronic inflammatory process. During the procedure contrasted radiologic images were performed to assure Spyscope location. Following cholangioscopy evaluation, a Roux-en-Y hepaticojejunostomy was performed. To enlarge hepatic duct, a small longitudinal incision was made, and a PDS-5.0 running suture was used for bilioenteric anastomosis. Patient was discharged on postoperative day 6, with drain removal on day 20. CONCLUSION: SpyGlass cholangioscopy during laparoscopic hepaticojejunostomy is feasible leading to minimal additional invasion of the surgical. In this case the method was performed safely, providing detailed examination of injured biliary ducts, adding elements to determine disease prognosis and patient care. |
format | Online Article Text |
id | pubmed-7750126 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-77501262020-12-23 Laparoscopic SpyGlass cholangioscopy evaluation during bilioenteric anastomosis for hepatolithiasis, a case report Figueira, Estela Regina Ramos Franzini, Tomazo Costa, Thiago Nogueira Madruga-Neto, Antonio Coutinho Guedes, Hugo Gonçalo Romano, Vitor Carminatti Ceconello, Ivan de Moura, Eduardo Guimarães Hourneaux Int J Surg Case Rep Case Report INTRODUCTION: Careful evaluation of intrahepatic injury of biliary tract diseases is crucial to assure proper management and estimate disease prognosis. Hepatholithiasis is a rare condition that can be associated to cholestatic liver diseases. Additional tools to improve diagnosis and patient care are of great interest specially if associated to decreased morbidity. Recently the spread of single-operator platforms of cholangioscopy brought this procedure back to scene. Our aim was to identify safety, feasibility and utility of SpyGlass cholangioscopy of biliary tract during laparoscopic hepaticojejunostomy. PRESENTATION OF CASE: A 53 years-old man with hepatolithiasis associated to choledolithiasis under treatment with ursodeoxycholic acid and fenofibrate for 8 months, was submitted to laparoscopic hepaticojejunostomy with cholangioscopy for biliary duct evaluation. Spyscope was inserted through a right lateral laparoscopic trocar entering the common bile duct. Examination of intra-hepatic bile ducts showed injury of right biliary. Few microcalculi were visualized. Left biliary ducts presented normal mucosa. Histopathological examination showed a chronic inflammatory process. During the procedure contrasted radiologic images were performed to assure Spyscope location. Following cholangioscopy evaluation, a Roux-en-Y hepaticojejunostomy was performed. To enlarge hepatic duct, a small longitudinal incision was made, and a PDS-5.0 running suture was used for bilioenteric anastomosis. Patient was discharged on postoperative day 6, with drain removal on day 20. CONCLUSION: SpyGlass cholangioscopy during laparoscopic hepaticojejunostomy is feasible leading to minimal additional invasion of the surgical. In this case the method was performed safely, providing detailed examination of injured biliary ducts, adding elements to determine disease prognosis and patient care. Elsevier 2020-12-13 /pmc/articles/PMC7750126/ /pubmed/33340982 http://dx.doi.org/10.1016/j.ijscr.2020.12.013 Text en © 2020 The Authors. Published by Elsevier Ltd on behalf of IJS Publishing Group Ltd. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Case Report Figueira, Estela Regina Ramos Franzini, Tomazo Costa, Thiago Nogueira Madruga-Neto, Antonio Coutinho Guedes, Hugo Gonçalo Romano, Vitor Carminatti Ceconello, Ivan de Moura, Eduardo Guimarães Hourneaux Laparoscopic SpyGlass cholangioscopy evaluation during bilioenteric anastomosis for hepatolithiasis, a case report |
title | Laparoscopic SpyGlass cholangioscopy evaluation during bilioenteric anastomosis for hepatolithiasis, a case report |
title_full | Laparoscopic SpyGlass cholangioscopy evaluation during bilioenteric anastomosis for hepatolithiasis, a case report |
title_fullStr | Laparoscopic SpyGlass cholangioscopy evaluation during bilioenteric anastomosis for hepatolithiasis, a case report |
title_full_unstemmed | Laparoscopic SpyGlass cholangioscopy evaluation during bilioenteric anastomosis for hepatolithiasis, a case report |
title_short | Laparoscopic SpyGlass cholangioscopy evaluation during bilioenteric anastomosis for hepatolithiasis, a case report |
title_sort | laparoscopic spyglass cholangioscopy evaluation during bilioenteric anastomosis for hepatolithiasis, a case report |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7750126/ https://www.ncbi.nlm.nih.gov/pubmed/33340982 http://dx.doi.org/10.1016/j.ijscr.2020.12.013 |
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