Single-operator cholangioscopy system for management of acute cholecystitis secondary to choledocholithiasis - PubMed (original) (raw)

. 2023 Dec 12;11(12):E1138-E1142.

doi: 10.1055/a-2201-6871. eCollection 2023 Dec.

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Single-operator cholangioscopy system for management of acute cholecystitis secondary to choledocholithiasis

Liying Tao et al. Endosc Int Open. 2023.

Abstract

This study aimed to investigate the safety and efficacy of endoscopic retrograde cholangiopancreatography (ERCP) + EyeMax (single-operator cholangioscopy system; SOC) (i.e., ERCP+SOC) for the treatment of choledocholithasis-associated acute cholecystitis. Twenty-five patients were evaluated between January 2022 and June 2023. The success rate (technical + clinical), procedure time, postoperative recovery, postoperative length of hospital stay, and complications rates were recorded. The procedure and clinical success rates were 92% (23/25) and 96% (24/25), respectively. The mean procedure time was 36.6±10 minutes (standard deviation [SD]). The average postoperative hospitalization was 2±0.8 days. No adverse events such as bleeding, perforation, or bile leakage occurred. Cholecystitis did not recur during the 2 to 18 months of follow-up. ERCP+SOC may be a feasible, safe, and effective alternative treatment for acute cholecystitis secondary to choledocholithiasis. ERCP+SOC was able to simultaneously resolve both biliary tract and gallbladder problems via natural orifice endoscopy. Its advantages included no skin wound, reduced postoperative pain, quick recovery, limited to no exposure to x-rays, and a short hospital stay.

Keywords: Cholangioscopy; Stones.

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/).

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Conflict of interest statement

Conflict of Interest The authors declare that they have no conflict of interest.

Figures

Fig. 1

Fig. 1

aSOC view of the common bile duct, which shows slightly hyperemic and edematous mucosa at the end of the common bile duct.bSOC imaging of the opening of the cystic duct, which shows obviously hyperemic and edematous mucosa.cLarge amount of pus and bile mud attached to the gallbladder wall is seen after entering into the gallbladder under guidewire guidance.dThe yellow soft texture stones in the gallbladder cavity can be seen before the lavage.eFluid in the gallbladder cavity is suctioned by negative pressure, and the structure of the gallbladder wall and the shape of the blood vessels are clearly observed.fX-ray image of indwelling nasobiliary drainage in the gallbladder cavity and indwelling pigtail-type plastic stent in the bile duct.

Fig. 2

Fig. 2

aThe wall of the common bile duct is smooth and there is no pus attached after the procedure (complete irrigation).bThe upper left opening is the opening of the cystic duct without any hyperemia, edema, no pus, the lower right opening is the common hepatic canal.cThe cervical canal of the gallbladder and the Heister valve are clearly visible.dThe gallbladder wall is clear, and there is no pus and stone residue compared with the preoperative view.eThe superficial vessels of the mucosa at the base of the gallbladder are multi-trunk branches.fThe superficial blood vessels of the mucosa of the gallbladder body after drainage are clearly visible and show trunk + network branches.

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