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| 1 | Diagnostic and therapeutic direct peroral cholangioscopy using an intraductal anchoring balloon显示文摘AIM:To report our experience using a recently introduced anchoring balloon for diagnostic and therapeutic direct peroral cholangioscopy(DPOC).METHODS:Consecutive patients referred for diagnostic or therapeutic peroral cholangioscopy were evaluated in a prospective cohort study.The patients underwent DPOC using an intraductal anchoring balloon,which was recently introduced to allow consistent access to the biliary tree with an ultraslim upper endoscope.The device was later voluntarily withdrawn from the market by the manufacturer.RESULTS:Fourteen patients underwent DPOC using the anchoring balloon.Biliary access with an ultraslim upper endoscope was accomplished in all 14 patients.In 12(86%) patients,ductal access required sphincteroplasty with a 10-mm dilating balloon.Intraductal placement of the ultraslim upper endoscope allowed satisfactory visualization of the biliary mucosa to the level of the confluence of the right and left hepatic ducts in 13 of 14 patients(93%).Therapeutic interventions by DPOC were successfully completed in all five attempted cases(intraductal biopsy in one and DPOC guided laser lithotripsy in four).Adverse events occurred in a patient on immunosuppressive therapy who developed an intrahepatic biloma at the site of the anchoring balloon.This required hospitalization and antibiotics.Repeat endoscopic retrograde cholangiopancreatography 8 wk after the index procedure showed resolution of the biloma.CONCLUSION:Use of this anchoring balloon allowed consistent access to the biliary tree for performance of diagnostic and therapeutic DPOC distal to the biliary bifurcation. | Mansour A Parsi Tyler Stevens John J Vargo | 2012 | World Journal of Gastroenterology2012，18，30： | 8 |
| 2 | Residual common bile duct stones on direct peroral cholangioscopy using ultraslim endoscope显示文摘AIM:To detect and manage residual common bile duct(CBD)stones using ultraslim endoscopic peroral cholangioscopy(POC)after a negative balloon-occluded cholangiography.METHODS:From March 2011 to December 2011,a cohort of 22 patients with CBD stones who underwent both endoscopic retrograde cholangiography(ERC)and direct POC were prospectively enrolled in this study.Those patients who were younger than 20 years of age,pregnant,critically ill,or unable to provide informed consent for direct POC,as well as those with concomitant gallbladder stones or CBD with diameters less than 10 mm were excluded.Direct POC using an ultraslim endoscope with an overtube balloon-assisted technique was carried out immediately after a negative balloon-occluded cholangiography was obtained.RESULTS:The ultraslim endoscope was able to be advanced to the hepatic hilum or the intrahepatic bile duct(IHD)in 8 patients(36.4%),to the extrahepatic bile duct where the hilum could be visualized in 10 patients(45.5%),and to the distal CBD where the hilum could not be visualized in 4 patients(18.2%).The procedure time of the diagnostic POC was 8.2 ± 2.9 min(range,5-18 min).Residual CBD stones were found in 5(22.7%)of the patients.There was one residual stone each in 3 of the patients,three in 1 patient,and more than five in 1 patient.The diameter of the residual stones ranged from 2-5 mm.In 2 of the patients,the residual stones were successfully extracted using either a retrieval balloon catheter(n = 1)or a basket catheter(n = 1)under direct endoscopic control.In the remaining 3 patients,the residual stones were removed using an irrigation and suction method under direct endoscopic visualization.There were no serious procedure-related complications,such as bleeding,pancreatitis,biliary tract infection,or perforation,in this study.CONCLUSION:Direct POC using an ultraslim endoscope appears to be a useful tool for both detecting and treating residual CBD stones after conventional ERC. | Shu-Wei Huang Cheng-Hui Lin Mu-Shien Lee Yung-Kuan Tsou Kai-Feng Sung | 2013 | World Journal of Gastroenterology2013，19，30： | 7 |
| 3 | SpyGlass系统在胰腺囊性肿瘤诊断中的应用显示文摘胰腺作为被众多器官包绕的腹膜后器官,传统影像学技术对其观察较局限,不能清晰地显示病变情况。SpyGlass系统自2005年问世以来得到越来越广泛的应用,在胰胆管疾病的诊断和治疗方面展现出其巨大的优势。胰腺囊性肿瘤(PCNs)是一种较罕见的胰腺疾病,随着医学影像学的发展,其检出率逐渐提高,但由于经验的缺乏,明确诊断仍有局限。SpyGlass系统对于胰腺囊性肿瘤诊断的作用成为一个新的研究方向。 | 姜蕾 令狐恩强 李惠凯 柴宁莉 | 2016 | 中华胃肠内镜电子杂志2016，3，1： | 7 |
| 4 | SpyGlass内镜直视系统在胆胰管狭窄及胆管巨大结石中的诊治作用显示文摘目的评估SpyGlass内镜直视系统对胆管、胰管狭窄的性质判断及胆管巨大结石的诊治效果。方法收集2012年9月—2018年8月期间因不明原因胆管、胰管狭窄或胆管巨大结石在杭州市第一人民医院行SpyGlass诊治的患者资料。采用SpyGlass视觉诊断不明原因胆胰管狭窄,部分患者行Spybite活检;胆管巨大结石采用SpyGlass直视联合激光碎石治疗。分析SpyGlass诊治的操作成功率、临床成功率和并发症发生率。结果共114例胆管狭窄、11例胰管狭窄和19例胆管巨大结石患者接受了SpyGlass诊治,总操作成功率为98.6%(142/144)。SpyGlass视觉诊断不明原因胆管狭窄性质的灵敏度、特异度、准确率、阳性预测值和阴性预测值分别为97.1%(67/69)、95.3%(41/43)、96.4%(108/112)、97.1%(67/69)和95.3%(41/43)。SpyGlass视觉诊断不明原因胰管狭窄性质的准确率为100.0%(11/11)。19例巨大胆管结石患者的碎石率为89.5%(17/19),首次取石成功率为73.7%(14/19),5例首次取石失败的患者二次取石均成功,总取石成功率为100.0%(19/19)。共4例(2.8%)患者出现术后并发症,其中急性胆管炎3例、轻症急性胰腺炎1例。结论SpyGlass诊断不明原因胆管、胰管狭窄准确、安全;SpyGlass联合激光碎石治疗胆管巨大结石安全、有效。 | 王雨承 金杭斌 黄海涛 楼奇峰 张筱凤 杨建锋 | 2020 | 中华消化内镜杂志2020，37，9： | 5 |
| 5 | 新一代SpyGlass单人操作胆道镜系统诊疗不明性质胆道狭窄的研究进展显示文摘目的 胆道狭窄病因复杂,其良恶性的早期诊断对患者的治疗及预后有重要的指导意义。近年来胆道镜技术不断发展,新一代的SpyGlass单人操作经口胆道镜具有视觉诊断和直视下针对活检的优势,可提高性质不明胆道狭窄的诊断准确性。此外,SpyGlass可通过自然通道解决部分胆道狭窄的问题,降低了外科手术需求。SpyGlass在实际应用当中不可避免会出现相关术后并发症和使用局限性。目前国内对SpyGlass系统诊治胆道狭窄的认知方面尚无统一共识,我们回顾了SpyGlass的最新进展,进一步阐明了SpyGlass的诊断性能、治疗干预、并发症及其局限性,就新一代SpyGlass系统对胆道狭窄的诊疗进展作一综述。 | 陈康迪 殷霖霖 缪林 季国忠 张秀华 | 2022 | 现代消化及介入诊疗2022，27，3： | 4 |
| 6 | Current endoscopic approach to indeterminate biliary strictures显示文摘Biliary strictures are considered indeterminate when basic work-up, including transabdominal imaging and endoscopic retrograde cholangiopancreatography with routine cytologic brushing, are non-diagnostic. Indeterminate biliary strictures can easily be mischaracterized which may dramatically affect patient's outcome. Early and accurate diagnosis of malignancy impacts not only a patient's candidacy for surgery, but also potential timely targeted chemotherapies. A significant portion of patients with indeterminate biliary strictures have benign disease and accurate diagnosis is, thus, paramount to avoid unnecessary surgery. Current sampling strategies have suboptimal accuracy for the diagnosis of malignancy. Emerging data on other diagnostic modalities, such as ancillary cytology techniques, single operator cholangioscopy, and endoscopic ultrasonography-guided fine needle aspiration, revealed promising results with much improved sensitivity. | David W Victor Stuart Sherman Tarkan Karakan Mouen A Khashab | 2012 | World Journal of Gastroenterology2012，18，43： | 3 |
| 7 | Endoscopic lithotripsy with peroral direct cholangioscopy using a conventional endoscope显示文摘Recently,peroral direct cholangioscopy(PDCS) using an ultra-slim endoscope has come into the spotlight.However,the working channel is too small to use various devices for lithotripsy.We report a case of endoscopic lithotripsy with PDCS using a conventional endoscope as a cholangioscope.Computed tomography scan on an 80-year-old female who was admitted with acute cholangitis showed two large stones in the bile duct.Endoscopic retrograde cholangiopancreatography was attempted first.However,mechanical lithotripsy failed because the stone was too large for the basket catheter.Finally,electric hydraulic lithotripsy with PDCS using a conventional endoscope was performed allowed the stones to be cleared completely.In conclusion,PDCS using a conventional endoscope can be an alternative solution for endoscopic lithotripsy for patients with large stones in the dilated bile duct. | So Nakaji Nobuto Hirata Toshiyasu Shiratori Masayoshi Kobayashi Masami Inase | 2013 | World Journal of Gastrointestinal Endoscopy2013，5，3： | 2 |
| 8 | Direct peroral cholangioscopy显示文摘Peroral cholangioscopy is an important tool for diagnosis and treatment of various biliary disorders. Peroral cholangioscopy can be performed by using a dedicated cholangioscope that is advanced through the accessory channel of a duodenoscope, or by direct insertion of a small-diameter endoscope into the bile duct. Direct peroral cholangioscopy refers to insertion of an ultraslim endoscope directly into the bile duct for visualization of the biliary mucosa and lumen. This approach provides a valuable and economic solution for diagnostic and therapeutic applications in the biliary tree. Compared to ductoscopy using a dedicated cholangioscope, the direct approach has several advantages and disadvantages. In this editorial, I discuss the advantages, disadvantages, and possible future developments pertaining to direct peroral cholangioscopy. | Mansour A Parsi | 2014 | World Journal of Gastrointestinal Endoscopy2014，6，1： | 0 |
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