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pmid: 25296087
Context Direct endoscopic visualization of biliopancreatic duct is certainly one of the greatest advances of therapeutic endoscopy. The use of a single-operator cholangioscopy platform (SpyGlass) is a promising technique in the evaluation of diseases such as indeterminate biliary stricture and giant choledocholitiasis. This is the first Brazilian case series using this technology. Methods We report a case series of 20 patients in whom SpyGlass was used with diagnostic and therapeutic intention. Results Most patients were female (60%) and the median age was 48 years (ranging from 14 to 94). Choledocholitiasis was the most common indication (12/20), and electrohydraulic lithotripsy was applied in eight (66%). Electrohydraulic lithotripsy was successful in seven (87.5%) patients. Partial stone fragmentation occurred in one patient with large stone causing stone-choledochal disproportion, which was conducted with biliary plastic stent placement and a second scheduled endoscopic approach in 3 months. In cases of undefined etiology of biliary strictures, it was possible to exclude malignancy due to direct visualization (7/8) or biopsy (1/8). One complication occurred (duodenal perforation) after papillary balloon dilation. Conclusion The use of SpyGlass demonstrated the benefits, especially in cases of large bile duct stones and indeterminate biliary strictures. Other potencial improvements such as reduction on radiation exposure should be confirmed in prospective studies.
Adult, Male, Adolescent, Gallstones, RC799-869, Bile Duct Diseases, Coledocolitíase, Young Adult, Lithotripsy, Humans, Endoscopy, Digestive System, Prospective Studies, Aged, Aged, 80 and over, Diseases of the digestive system. Gastroenterology, Middle Aged, Choledocholithiasis, Litotripsia, Treatment Outcome, Cálculos biliares, Colangiografia, utilização, Cholangiography, utilization, Female
Adult, Male, Adolescent, Gallstones, RC799-869, Bile Duct Diseases, Coledocolitíase, Young Adult, Lithotripsy, Humans, Endoscopy, Digestive System, Prospective Studies, Aged, Aged, 80 and over, Diseases of the digestive system. Gastroenterology, Middle Aged, Choledocholithiasis, Litotripsia, Treatment Outcome, Cálculos biliares, Colangiografia, utilização, Cholangiography, utilization, Female
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