Suzuki Yuichi, Ishii Tomohiro, Miwa Haruo, Sato Takeshi, Goda Yoshihiro, Irie Kuniyasu, Sugimori Kazuya, Maeda Shin
Department of Gastroenterology, Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Japan.
Gastroenterological Center, Yokohama City University Medical Center, Yokohama 232-0024, Japan.
Diagnostics (Basel). 2024 Nov 18;14(22):2589. doi: 10.3390/diagnostics14222589.
Peroral cholangioscopy (POCS) is valuable for assessing malignant biliary strictures; however, biliary drainage prior to POCS often hinders accurate diagnosis. This retrospective study aimed to investigate the feasibility of POCS using a newly developed cholangioscope, CHF-B290, during initial endoscopic retrograde cholangiopancreatography (ERCP) for malignant biliary strictures. This multicenter retrospective study included patients who underwent initial ERCP for malignant biliary strictures at two institutions between January 2018 and March 2022. Patients who underwent initial ERCP with POCS were classified into the POCS group, and those without POCS were classified into the non-POCS group. To prevent post-POCS cholangitis, the original irrigation system for CHF-B290 was used in all POCS examinations. The primary endpoint was the rate of post-ERCP biliary infections, and the secondary endpoints were other ERCP-related complications, including pancreatitis, bleeding, and perforation. Overall, 53 and 94 patients were included in the POCS and non-POCS groups, respectively. For the primary endpoint, the rate of post-ERCP biliary infection was not significantly different between the two groups (1.9% vs. 5.3%, = 0.42). For the secondary endpoints, no significant differences were observed in the rates of post-ERCP pancreatitis (5.7% vs. 6.4%, = 1.00) and other ERCP-related complications. The overall complication rate was 9.4% in the POCS group and 13% in the non-POCS group ( = 0.60). POCS during the initial ERCP for malignant biliary strictures is feasible.
经口胆管镜检查（POCS）对于评估恶性胆管狭窄很有价值；然而，POCS前的胆管引流常常会妨碍准确诊断。本回顾性研究旨在探讨在初次内镜逆行胰胆管造影（ERCP）期间使用新开发的胆管镜CHF - B290对恶性胆管狭窄进行POCS的可行性。这项多中心回顾性研究纳入了2018年1月至2022年3月期间在两家机构接受初次ERCP治疗恶性胆管狭窄的患者。接受初次ERCP并进行POCS的患者被分为POCS组，未进行POCS的患者被分为非POCS组。为预防POCS后胆管炎，所有POCS检查均使用CHF - B290的原装冲洗系统。主要终点是ERCP后胆管感染率，次要终点是其他与ERCP相关的并发症，包括胰腺炎、出血和穿孔。总体而言，POCS组和非POCS组分别纳入了53例和94例患者。对于主要终点，两组之间ERCP后胆管感染率无显著差异（1.9%对5.3%，P = 0.42）。对于次要终点，ERCP后胰腺炎发生率（5.7%对6.4%，P = 1.00）和其他与ERCP相关的并发症发生率均无显著差异。POCS组的总体并发症发生率为9.4%，非POCS组为13%（P = 0.60）。在初次ERCP期间对恶性胆管狭窄进行POCS是可行的。
