Department of Gastroenterology, Georges-Pompidou European Hospital, APHP.Centre, Paris, France.
University of Paris-Cité, Paris, France.
Dig Endosc. 2024 Jun;36(6):719-725. doi: 10.1111/den.14697. Epub 2023 Oct 31.
A new short device for percutaneous endoscopic cholangioscopy was recently developed. However, feasibility and safety has not yet been evaluated. The aim of this study was to assess clinical success, technical success, and adverse events (AEs).
This observational multicenter retrospective study included all patients who underwent percutaneous cholangioscopy using a short cholangioscope between 2020 and 2022. The clinical success, defined as the complete duct clearance or obtaining at least one cholangioscopy-guided biopsy, was assessed. The histopathological accuracy, technical success, and the AE rate were also evaluated.
Fifty-one patients (60 ± 15 years, 45.1% male) were included. The majority of patients had altered anatomy (n = 40, 78.4%), and biliary stones (n = 34, 66.7%) was the commonest indication. The technique was predominantly wire-guided (n = 44, 86.3%) through a percutaneous sheath (n = 36, 70.6%) following a median interval of 8.5 days from percutaneous drainage. Cholangioscopy-guided electrohydraulic lithotripsy was performed in 29 cases (56.9%), combined with a retrieval basket in eight cases (27.6%). The clinical success was 96.6%, requiring a median of one session (range 1-3). Seventeen patients (33.3%) underwent cholangioscopy-guided biopsies. There were four (7.8%) cholangioscopy-related AEs (cholangitis and peritonitis). Overall, the technical success and AE rates were 100% and 19.6%, respectively, in a median follow-up of 7 months.
Percutaneous endoscopic cholangioscopy with a new short device is effective and safe, requiring a low number of sessions to achieve duct clearance or accurate histopathological diagnosis.
最近开发了一种用于经皮内镜逆行胆胰管造影术的新型短型器械。然而，其可行性和安全性尚未得到评估。本研究旨在评估临床成功率、技术成功率和不良事件（AE）。
本观察性多中心回顾性研究纳入了 2020 年至 2022 年间所有接受新型短型胆管镜经皮胆管镜检查的患者。评估了临床成功率（定义为完全胆管清除或获得至少一次胆管镜引导下活检）。还评估了组织病理学准确性、技术成功率和 AE 发生率。
共纳入 51 例患者（60±15 岁，45.1%为男性）。大多数患者存在解剖结构改变（n=40，78.4%），最常见的适应证是胆管结石（n=34，66.7%）。该技术主要通过经皮鞘管（n=36，70.6%）进行导丝引导（n=44，86.3%），经皮引流后中位数间隔 8.5 天。29 例（56.9%）患者进行了胆管镜引导下的电液压碎石术，其中 8 例（27.6%）联合使用了取石篮。临床成功率为 96.6%，中位数需要 1 次（范围 1-3）。17 例（33.3%）患者行胆管镜引导下活检。有 4 例（7.8%）发生与胆管镜相关的 AE（胆管炎和腹膜炎）。在中位随访 7 个月时，总体上技术成功率和 AE 发生率分别为 100%和 19.6%。
使用新型短型器械行经皮内镜逆行胆胰管造影术是有效且安全的，需要较少的次数即可实现胆管清除或准确的组织病理学诊断。
