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Clinical Outcomes of Digital Cholangioscopy-Guided Procedures for the Diagnosis of Biliary Strictures and Treatment of Difficult Bile Duct Stones: A Single-Center Large Cohort Study

Although Spy DS (SpyGlass DS Direct Visualization System) is considered to be useful for the diagnosis of bile duct strictures and the treatment of bile duct stones, there is limited data to date validating its efficacy. We hence retrospectively evaluated the clinical outcomes of the use of Spy DS i...

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Autores principales: Minami, Hirohito, Mukai, Shuntaro, Sofuni, Atsushi, Tsuchiya, Takayoshi, Ishii, Kentaro, Tanaka, Reina, Tonozuka, Ryosuke, Honjo, Mitsuyoshi, Yamamoto, Kenjiro, Nagai, Kazumasa, Matsunami, Yukitoshi, Asai, Yasutsugu, Kurosawa, Takashi, Kojima, Hiroyuki, Homma, Toshihiro, Itoi, Takao
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8069886/
https://www.ncbi.nlm.nih.gov/pubmed/33921514
http://dx.doi.org/10.3390/jcm10081638
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author Minami, Hirohito
Mukai, Shuntaro
Sofuni, Atsushi
Tsuchiya, Takayoshi
Ishii, Kentaro
Tanaka, Reina
Tonozuka, Ryosuke
Honjo, Mitsuyoshi
Yamamoto, Kenjiro
Nagai, Kazumasa
Matsunami, Yukitoshi
Asai, Yasutsugu
Kurosawa, Takashi
Kojima, Hiroyuki
Homma, Toshihiro
Itoi, Takao
author_facet Minami, Hirohito
Mukai, Shuntaro
Sofuni, Atsushi
Tsuchiya, Takayoshi
Ishii, Kentaro
Tanaka, Reina
Tonozuka, Ryosuke
Honjo, Mitsuyoshi
Yamamoto, Kenjiro
Nagai, Kazumasa
Matsunami, Yukitoshi
Asai, Yasutsugu
Kurosawa, Takashi
Kojima, Hiroyuki
Homma, Toshihiro
Itoi, Takao
author_sort Minami, Hirohito
collection PubMed
description Although Spy DS (SpyGlass DS Direct Visualization System) is considered to be useful for the diagnosis of bile duct strictures and the treatment of bile duct stones, there is limited data to date validating its efficacy. We hence retrospectively evaluated the clinical outcomes of the use of Spy DS in a large number of patients. A total of 183 patients who underwent Spy DS-guided procedures for indeterminate bile duct strictures (n = 93) and bile duct stones (n = 90) were analyzed retrospectively. All patients (93/93) with bile duct strictures successfully underwent visual observation, and 95.7% (89/93) of these patients successfully underwent direct biopsy. The sensitivity, specificity, and overall accuracy were 94.7%, 83.3%, and 90.3%, respectively, for visual impression; 80.9%, 100%, and 89.2%, respectively, for histopathological analysis of a direct biopsy; and 96.5%, 91.7%, and 94.6%, respectively, for visual impression combined with biopsy. Successful visualization of the stones was achieved in 98.9% (89/90) of the patients, and complete stone removal was achieved in 92.2% (83/90) of the patients, with an average of 3.3 procedures. The adverse events rate was 17.5% (32/183; cholangitis in 15 patients, fever the following day in 25, pancreatitis in 1, hemorrhage in 1, and gastrointestinal perforation in 1). No administration of antibiotics before the procedure was found to be a statistically significant risk factor for the development of fever after the procedure (p < 0.01). Spy DS-guided procedures are effective for the diagnosis and treatment of bile duct lesions and can be performed with a low risk of serious adverse events.
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spelling pubmed-80698862021-04-26 Clinical Outcomes of Digital Cholangioscopy-Guided Procedures for the Diagnosis of Biliary Strictures and Treatment of Difficult Bile Duct Stones: A Single-Center Large Cohort Study Minami, Hirohito Mukai, Shuntaro Sofuni, Atsushi Tsuchiya, Takayoshi Ishii, Kentaro Tanaka, Reina Tonozuka, Ryosuke Honjo, Mitsuyoshi Yamamoto, Kenjiro Nagai, Kazumasa Matsunami, Yukitoshi Asai, Yasutsugu Kurosawa, Takashi Kojima, Hiroyuki Homma, Toshihiro Itoi, Takao J Clin Med Article Although Spy DS (SpyGlass DS Direct Visualization System) is considered to be useful for the diagnosis of bile duct strictures and the treatment of bile duct stones, there is limited data to date validating its efficacy. We hence retrospectively evaluated the clinical outcomes of the use of Spy DS in a large number of patients. A total of 183 patients who underwent Spy DS-guided procedures for indeterminate bile duct strictures (n = 93) and bile duct stones (n = 90) were analyzed retrospectively. All patients (93/93) with bile duct strictures successfully underwent visual observation, and 95.7% (89/93) of these patients successfully underwent direct biopsy. The sensitivity, specificity, and overall accuracy were 94.7%, 83.3%, and 90.3%, respectively, for visual impression; 80.9%, 100%, and 89.2%, respectively, for histopathological analysis of a direct biopsy; and 96.5%, 91.7%, and 94.6%, respectively, for visual impression combined with biopsy. Successful visualization of the stones was achieved in 98.9% (89/90) of the patients, and complete stone removal was achieved in 92.2% (83/90) of the patients, with an average of 3.3 procedures. The adverse events rate was 17.5% (32/183; cholangitis in 15 patients, fever the following day in 25, pancreatitis in 1, hemorrhage in 1, and gastrointestinal perforation in 1). No administration of antibiotics before the procedure was found to be a statistically significant risk factor for the development of fever after the procedure (p < 0.01). Spy DS-guided procedures are effective for the diagnosis and treatment of bile duct lesions and can be performed with a low risk of serious adverse events. MDPI 2021-04-12 /pmc/articles/PMC8069886/ /pubmed/33921514 http://dx.doi.org/10.3390/jcm10081638 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Minami, Hirohito
Mukai, Shuntaro
Sofuni, Atsushi
Tsuchiya, Takayoshi
Ishii, Kentaro
Tanaka, Reina
Tonozuka, Ryosuke
Honjo, Mitsuyoshi
Yamamoto, Kenjiro
Nagai, Kazumasa
Matsunami, Yukitoshi
Asai, Yasutsugu
Kurosawa, Takashi
Kojima, Hiroyuki
Homma, Toshihiro
Itoi, Takao
Clinical Outcomes of Digital Cholangioscopy-Guided Procedures for the Diagnosis of Biliary Strictures and Treatment of Difficult Bile Duct Stones: A Single-Center Large Cohort Study
title Clinical Outcomes of Digital Cholangioscopy-Guided Procedures for the Diagnosis of Biliary Strictures and Treatment of Difficult Bile Duct Stones: A Single-Center Large Cohort Study
title_full Clinical Outcomes of Digital Cholangioscopy-Guided Procedures for the Diagnosis of Biliary Strictures and Treatment of Difficult Bile Duct Stones: A Single-Center Large Cohort Study
title_fullStr Clinical Outcomes of Digital Cholangioscopy-Guided Procedures for the Diagnosis of Biliary Strictures and Treatment of Difficult Bile Duct Stones: A Single-Center Large Cohort Study
title_full_unstemmed Clinical Outcomes of Digital Cholangioscopy-Guided Procedures for the Diagnosis of Biliary Strictures and Treatment of Difficult Bile Duct Stones: A Single-Center Large Cohort Study
title_short Clinical Outcomes of Digital Cholangioscopy-Guided Procedures for the Diagnosis of Biliary Strictures and Treatment of Difficult Bile Duct Stones: A Single-Center Large Cohort Study
title_sort clinical outcomes of digital cholangioscopy-guided procedures for the diagnosis of biliary strictures and treatment of difficult bile duct stones: a single-center large cohort study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8069886/
https://www.ncbi.nlm.nih.gov/pubmed/33921514
http://dx.doi.org/10.3390/jcm10081638
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