METHODS: This observational multicenter retrospective study included all patients who underwent percutaneous cholangioscopy using a short cholangioscope between 2020 and 2022. The clinical success, defined as the complete duct clearance or obtaining at least one cholangioscopy-guided biopsy, was assessed. The histopathological accuracy, technical success, and the AE rate were also evaluated.
RESULTS: Fifty-one patients (60 ± 15 years, 45.1% male) were included. The majority of patients had altered anatomy (n = 40, 78.4%), and biliary stones (n = 34, 66.7%) was the commonest indication. The technique was predominantly wire-guided (n = 44, 86.3%) through a percutaneous sheath (n = 36, 70.6%) following a median interval of 8.5 days from percutaneous drainage. Cholangioscopy-guided electrohydraulic lithotripsy was performed in 29 cases (56.9%), combined with a retrieval basket in eight cases (27.6%). The clinical success was 96.6%, requiring a median of one session (range 1-3). Seventeen patients (33.3%) underwent cholangioscopy-guided biopsies. There were four (7.8%) cholangioscopy-related AEs (cholangitis and peritonitis). Overall, the technical success and AE rates were 100% and 19.6%, respectively, in a median follow-up of 7 months.
CONCLUSIONS: Percutaneous endoscopic cholangioscopy with a new short device is effective and safe, requiring a low number of sessions to achieve duct clearance or accurate histopathological diagnosis.
方法:这项观察性多中心回顾性研究纳入了所有在2020年至2022年期间使用短胆管镜行经皮胆管镜检查的患者。临床上的成功,定义为完全导管清除或获得至少一次胆管镜检查引导的活检,被评估。组织病理学的准确性,技术上的成功,并对AE率进行了评价。
结果:51名患者(60±15岁,男性占45.1%)。大多数患者的解剖结构改变(n=40,78.4%),胆道结石(n=34,66.7%)是最常见的适应症。该技术主要是在经皮引流的中位间隔为8.5天之后,通过经皮鞘管(n=36,70.6%)进行导线引导(n=44,86.3%)。行胆道镜引导下液电碎石29例(56.9%),8例(27.6%)加上取回篮。临床成功率为96.6%,需要一个疗程的中位数(范围1-3)。17例患者(33.3%)接受了胆道镜引导的活检。有4例(7.8%)胆道镜检查相关的不良事件(胆管炎和腹膜炎)。总的来说,技术成功率和AE率分别为100%和19.6%,分别,中位随访时间为7个月。
结论:使用新型短装置的经皮内镜胆道镜检查是有效且安全的,需要少量的会议来实现导管清除或准确的组织病理学诊断。