BACKGROUND： Peroral cholangioscopy facilitates diagnosis and therapy of biliary disorders. This study prospectively evaluated a new short access cholangioscopy. METHODS： Consecutive patients were included as follows...BACKGROUND： Peroral cholangioscopy facilitates diagnosis and therapy of biliary disorders. This study prospectively evaluated a new short access cholangioscopy. METHODS： Consecutive patients were included as follows： difficult stones （group 1） underwent cholangioscopy with electrohydraulic lithotripsy and indeterminate biliary strictures （group 2） were evaluated with macroscopic assessment and cholangioscopy guided biopsy sampling. We evaluated the complete stone clearance rate （group 1） and diagnostic accu- racy （group 2）. Follow-up was performed over a median of 13 and I6 months, respectively. RESULTS： Group 1 （n=21）： complete stone clearance defined as lack of stones in cholangiography and stone removal dur- ing cholangioscopy was achieved in 15 （71.4%） patients. Clini- cal stone clearance defined as lack of symptoms, laboratory abnormalities and hospital visits during follow-up, irrespec- tive of stone clearance was evident in 17 （81.0%） patients. One serious adverse event occurred （bile duct perforation）. Group 2 （n=28）： malignancy was confirmed in 15 patients. Sensitiv- ity, specificity and diagnostic accuracy of cholangioscopy were 85.7%, 75.0% and 80.7%, respectively. Sensitivity, specificity and diagnostic accuracy of biopsies were 54.5%, 100.0% and 72.2%, respectively. No serious adverse events occurred, and one patient was lost to follow-up.CONCLUSIONS： The novel system enabled complex stone treatment and biliary stricture diagnosis. Cholangioscopy outperformed direct biopsy regarding characterization of in- determinate strictures.展开更多
基金supported by a grant from Karl Storz GmbH,Tuttlingen,Germany
文摘BACKGROUND： Peroral cholangioscopy facilitates diagnosis and therapy of biliary disorders. This study prospectively evaluated a new short access cholangioscopy. METHODS： Consecutive patients were included as follows： difficult stones （group 1） underwent cholangioscopy with electrohydraulic lithotripsy and indeterminate biliary strictures （group 2） were evaluated with macroscopic assessment and cholangioscopy guided biopsy sampling. We evaluated the complete stone clearance rate （group 1） and diagnostic accu- racy （group 2）. Follow-up was performed over a median of 13 and I6 months, respectively. RESULTS： Group 1 （n=21）： complete stone clearance defined as lack of stones in cholangiography and stone removal dur- ing cholangioscopy was achieved in 15 （71.4%） patients. Clini- cal stone clearance defined as lack of symptoms, laboratory abnormalities and hospital visits during follow-up, irrespec- tive of stone clearance was evident in 17 （81.0%） patients. One serious adverse event occurred （bile duct perforation）. Group 2 （n=28）： malignancy was confirmed in 15 patients. Sensitiv- ity, specificity and diagnostic accuracy of cholangioscopy were 85.7%, 75.0% and 80.7%, respectively. Sensitivity, specificity and diagnostic accuracy of biopsies were 54.5%, 100.0% and 72.2%, respectively. No serious adverse events occurred, and one patient was lost to follow-up.CONCLUSIONS： The novel system enabled complex stone treatment and biliary stricture diagnosis. Cholangioscopy outperformed direct biopsy regarding characterization of in- determinate strictures.
