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DOI: 10.1055/s-0038-1637267
ADVERSE EVENTS IN PERFORMING SINGLE-OPERATOR PERORAL CHOLANGIOSCOPY: A COMPARISON OF SPYGLASS SYSTEM AND DIRECT POC UNDER CARBON DIOXIDE INSUFFLATION
Publication History
Publication Date:
27 March 2018 (online)
Aims:
Recently, single-operator peroral cholangioscopy (SOC) systems were introduced and its various clinical implications were reported. Although it has been reported to be safe procedure, data on adverse events related to the procedure is limited. The aim of this study was to evaluate the incidence of adverse events in performing SOC in comparison of SpyGlass Direct Visualization System (SDVS) and direct peroral cholangioscopy (DPOC) by using an ultra-slim endoscope.
Methods:
We evaluated patients who underwent an SOC from March 2014 to December 2016. SDVS was performed by using the SpyGlass Legacy or the SpyGlass DS system. DPOC was performed by using a multi-bending ultra-slim endoscope with carbon dioxide insufflation. Procedure-related adverse events were defined and assessed according to the consensus criteria.
Results:
Total 179 patients underwent SOC for various bile duct diseases. SDVS was performed in 102 patients and DPOC in 77 patients. Overall incidence of adverse events was 6.9% in SDVS group and 10.4% in DPOC group (p =0.399). Cholangitis was developed in 1% (1/102) in SDVS group and 2.6% (2/77) in DPOC group (p =0.578). Acute pancreatitis was occurred in 2.9% (3/102) and 3.9% (3/77) of both groups (p =0.725), and all cases had mild process. Hemobilia was in 2% (2/102) and 3.9% (3/77) of both group (p =0.653). Bile duct perforation was developed in one patient (1%) of SDVS group and resolved with conservative treatment. Acute cholecystitis or air embolism were not occurred in this study.
Conclusions:
The incidence of adverse events in performing SOC by SpyGlass system or DPOC under carbon dioxide insufflation was low with an acceptable safety profile. SOC may be useful modality for diagnostic or therapeutic purposes in various bile duct diseases.