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Management of pancreaticobiliary disease using a new intra-ductal endoscope:The Texas experience

World Journal of Gastroenterology 2009年第11期15卷 1353-1358页

作者： Douglas S Fishman Paul R Tarnasky Sandeep N Patel Isaac Raijman Texas Children’s Hospital Section of Pediatric Gastroenterology and NutritionBaylor College of Medicine6621 Fannin StreetHoustonTX 77030United States Digestive Health Associates Methodist Pavilion II 221 West Colorado Blvd.DallasTX 75208-2359United States Division of Gastroenterology and Nutrition The University of Texas Health Science Center at San Antonio7703 Floyd Curl Drive San AntonioTX 78229-3900United States Digestive Associates of Houston 6620 Main Street.HoustonTX 77030United States

AIM:To evaluate a new single-operator mini-endoscope, Spyglass,for its performance,feasibility and safety in the management of pancreaticobiliary disease. METHODS:In a multicenter retrospective analysis of patients undergoing intraductal endoscopy,we evaluated 128 patients(71 men,mean age 57.6 years).Indications were therapeutic(TX)in 72(56%) and diagnostic(DX)in 56(44%). RESULTS:Peroral endoscopy was performed in 121 and percutaneous in *** indications included CBD stones in 41,PD stones in six,and biliary strictures in *** indications included abnormal LFT’s in 15, abnormal imaging in 38 and cholangiocarcinoma staging in *** of the stone(s)was considered good in 31,fair in six,and poor in four. Advancement of the electrohydraulic lithotripsy probe was not possible in three patients and proper targeting of the lesion was partial in four patients.A holmium laser was used successfully in three *** clearance was achieved in 37 patients after one procedure and in four patients after two *** of biliary strictures was modified in 20/29 and confirmed to be malignant in 10/*** the modified patients,no diagnosis was available in *** demonstrated malignancy in 8/17 and non-malignancy in *** pathology by imaging studies and abnormal LFT’s was modified in 43/63(66%).Staging of cholangiocarcinoma demonstrated multicentric cholangiocarcinoma in 2/*** was no morbidity associated with the use of Spyglass. CONCLUSION:Spyglass Spyscopeis a first generation, single operator miniature endoscope that can evaluate and treat various biliary and pancreatic tract diseases.

关键词： Intra-ductal endoscopy Choledochoscopy Cholangiopancreatoscopy Endoscopic retrogradecholangiopancreatography Biliary disease Sclerosingcholangitis Cholangiocarcinoma Lithotripsy pancreaticdisease Spyglass

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