Digital single-operator cholangioscopy: a useful tool for selective guidewire placements across complex biliary strictures

Surgical Endoscopy
Arne BokemeyerFrank Lenze

Abstract

Treatment of biliary strictures is challenging. Digital single-operator cholangioscopes (SOCs) equipped with an improved imaging quality, were recently introduced and may be useful for selective guidewire placement in difficult biliary strictures. A total of 167 digital SOC procedures performed between 2015 and 2018 were retrospectively analyzed for successful guidewire placements across biliary strictures. Only cases with previous failed conventional guidewire placement approaches were included. In total, 30 examinations with a digital SOC-assisted guidewire placement across biliary strictures, performed in 23 patients, were identified. In 52% of all patients, the stricture was benign with post-liver-transplant strictures (75%) as the most frequent finding; in 48% of all patients the stricture was malignant with cholangiocellular carcinoma as the most frequent type (64%). Guidewire placement was successful in 21 of 30 procedures (70%). According to a subgroup analysis, digital SOC-assisted guidewire placements were significantly more successful in patients with benign strictures than those in patients with malignant strictures (88.2% vs. 46.2%; p = 0.02). Furthermore, the technical success rate tended to be increased in cases ...Continue Reading

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Jul 31, 2020·Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a·Margherita PizzicannellaSilvana Perretta
Feb 2, 2019·World Journal of Gastrointestinal Endoscopy·Petko KaragyozovIvan Tishkov
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