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

Area of Science:

• Gastroenterology and Hepatology
• Interventional Endoscopy

Background:

• Biliary stricture treatment presents significant clinical challenges.
• Digital single-operator cholangioscopes (SOCs) offer enhanced imaging for complex biliary interventions.

Purpose of the Study:

• To evaluate the efficacy of digital SOC-assisted guidewire placement in challenging biliary strictures.
• To compare success rates in benign versus malignant strictures and initial versus repeat procedures.

Main Methods:

• Retrospective analysis of 167 digital SOC procedures (2015-2018).
• Inclusion criteria: patients with prior failed conventional guidewire attempts.
• Focus on 30 procedures for guidewire placement across biliary strictures.

Main Results:

• Successful guidewire placement achieved in 70% (21/30) of procedures.
• Significantly higher success rates in benign strictures (88.2%) compared to malignant strictures (46.2%; p=0.02).
• Adverse events occurred in 16.7% of examinations.

Conclusions:

• Digital SOC-assisted guidewire placement is a technically successful approach for biliary strictures.
• The technique is particularly effective for benign strictures, offering an alternative to more invasive methods.