An international experience with single-operator cholangiopancreatoscopy in patients with altered anatomy.

Abstract

Background and study aims  The utility of digital single- operator cholangiopancreatoscopy (D-SOCP) in surgically altered anatomy (SAA) is limited. We aimed to evaluate the technical success and safety of D-SOCP in patients SAA. Patients and methods  Patients with SAA who underwent D-SOCP between February 2015 and June 2020 were retrospectively evaluated. Technical success was defined as completing the intended procedure with the use of D-SOCP. Results  Thirty-five patients underwent D-SOCP (34 D-SOC, 1 D-SOP). Bilroth II was the most common type of SAA (45.7 %), followed by Whipple reconstruction (31.4 %). Twenty-three patients (65.7 %) patients had prior failed ERCP due to the presence of complex biliary stone (52.2 %). A therapeutic duodenoscope was utilized in the majority of the cases (68.6 %), while a therapeutic gastroscope (22.7 %) or adult colonoscope (8.5 %) were used in the remaining procedures. Choledocholithiasis (61.2 %) and pancreatic duct calculi (3.2 %) were the most common indications for D-SOCP. Technical success was achieved in all 35 patients (100 %) and majority (91.4 %) requiring a single session. Complex interventions included electrohydraulic or laser lithotripsy, biliary or pancreatic stent placement, stricture dilation, and target tissue biopsies. Two mild adverse events occurred (pancreatitis and transient bacteremia). Conclusions  In SAA, D-SOCP is a safe and effective modality to diagnose and treat complex pancreatobiliary disorders, especially in cases where standard ERCP attempts may fail.

• Authors: Shruti Mony, Bachir Ghandour, Isaac Raijman, Amar Manvar, Sammy Ho, Arvind J Trindade, Petros C Benias, Claudio Zulli, Jérémie Jacques, Yervant Ichkhanian, Tobias Zuchelli, Mouhanna Abu Ghanimeh, Shayan Irani, Andrew Canakis, Omid Sanaei, Daniel Szvarca, Linda Zhang, Michael Bejjani, Venkata Akshintala, Mouen A Khashab
• Journal: Endoscopy international open (Endosc Int Open) Vol. 10 Issue 6 Pg. E898-E904 (Jun 2022) ISSN: 2364-3722 [Print] Germany
• PMID: 35692911 (Publication Type: Journal Article)
• Copyright: The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).