Percutaneous transhepatic cholangioscopy using a single-operator cholangioscope (pSOC), a retrospective,...

Area of Science:

• Gastroenterology and Hepatology
• Minimally Invasive Procedures
• Biliary Interventions

Background:

• Percutaneous cholangioscopy (PC) traditionally requires a large tract (16 Fr), increasing invasiveness.
• Standard PC scopes necessitate significant dilation, posing challenges for patients with altered anatomy.

Purpose of the Study:

• To evaluate the feasibility, safety, and efficacy of percutaneous single-operator cholangioscopy (pSOC) using the SpyGlass DS system.
• To assess pSOC for both diagnostic and therapeutic indications in percutaneous cholangioscopy.

Main Methods:

• Retrospective analysis of 28 patients undergoing pSOC across 4 tertiary centers.
• Evaluation of technical/clinical success, diagnostic accuracy (biopsies, visualization), and adverse events.
• Review of dilation requirements (number and size) for pSOC access.

Main Results:

• High technical and clinical success rate (96%) in 28 patients, 89% with altered anatomy.
• Excellent diagnostic accuracy: 100% for histopathology and 96.4% for visual impression.
• Low adverse event rate (10.7%) and reduced dilation needs (mean 1.25 dilatations, 11 Fr).

Conclusions:

• pSOC is a feasible, safe, and effective technique for percutaneous cholangioscopy.
• It offers a valuable alternative for patients with altered gastrointestinal anatomy.
• pSOC has the potential to minimize procedural risks and healthcare costs.