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Review
. 2020 Feb 29;10(3):132.
doi: 10.3390/diagnostics10030132.

The Expansion of Cholangioscopy: Established and Investigational Uses of SpyGlass in Biliary and Pancreatic Disorders

Michael Yodice  1 , Joseph Choma  2 , Micheal Tadros  1
Affiliations
Review

The Expansion of Cholangioscopy: Established and Investigational Uses of SpyGlass in Biliary and Pancreatic Disorders

Michael Yodice et al. Diagnostics (Basel). .

Abstract

Direct visualization of bile and pancreatic duct pathology is proving to be beneficial in patients where previous techniques have failed. Recent advancements in technology and the development of the SpyGlass system have led to an increased use of cholangioscopy. It is already known that SpyGlass is beneficial in patients with difficult bile duct stones and indeterminate biliary lesions through the use of targeted lithotripsy and visually guided biopsy. Cholangioscopy allows the visualization of hidden stone and guide wire placement across difficult strictures and selective cannulation of the intrahepatic and cystic ducts. It is also demonstrating its utility in investigational applications such as post-liver transplant and primary sclerosing cholangitis stricture treatment, evaluation of hemobilia, and guided radiofrequency ablation of ductal tumors. In addition to having clinical utility, cholangioscopy may also be cost-effective by limiting the number of repeat procedures. Cholangioscopy overall has similar complication rates compared to other standard endoscopic retrograde cholangioscopy (ERCP) techniques, but there may be higher rates of cholangitis. This could be mitigated with prophylactic antibiotic use, and overall, cholangioscopy has similar complication rates compared to other techniques.

Keywords: SpyGlass; cholangioscopy; difficult bile duct stones; indeterminate strictures; pancreatoscopy; primary sclerosing cholangitis.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
(A) Intrahepatic bile duct stone; (B) Positioning of the SpyGlass basket accessory around bile duct stone; (C) Removal of bile duct stone using SpyGlass basket accessory.
Figure 2
Figure 2
(A) Benign inflammatory bile duct stricture; (B) Stricture formation with malignant transformation.
Figure 3
Figure 3
Intraductal papillary neoplasm of the pancreatic duct.
Figure 4
Figure 4
(A) Pancreatic duct stone; (B) Passing of wire by pancreatic duct stone.
Figure 5
Figure 5
(A) Bile duct guidewire; (B) Passage of guidewire through stenosed bile duct.
See this image and copyright information in PMC

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