目的:最近开发了一种用于经皮内镜胆道镜检查的新型短装置。然而,可行性和安全性尚未评估。这项研究的目的是评估临床成功,技术上的成功,和不良事件(AE)。
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。
OBJECTIVE: A new short device for percutaneous endoscopic cholangioscopy was recently developed. However, feasibility and safety has not yet been evaluated. The aim of this
study was to assess clinical success, technical success, and adverse events (AEs).
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.