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Case Reports
. 2023 Jul 8;10(7):e01095.
doi: 10.14309/crj.0000000000001095. eCollection 2023 Jul.

A Unique Approach to Obtaining Tissue in a Difficult to Access Indeterminate Biliary Stricture: Percutaneous Cholangioscopy and Biopsy

Abigail Schubach  1 , Amulya Penmetsa  2 , Ashwani Sharma  3 , Shivangi Kothari  2
Affiliations
Case Reports

A Unique Approach to Obtaining Tissue in a Difficult to Access Indeterminate Biliary Stricture: Percutaneous Cholangioscopy and Biopsy

Abigail Schubach et al. ACG Case Rep J. .

Abstract

When evaluating biliary strictures, establishing a diagnosis can present challenges. The first-line approach of endoscopic retrograde cholangiopancreatography can often involve anatomic restrictions. Traditionally, percutaneous transhepatic cholangioscopy has been the answer for biopsies unable to be obtained with the modalities above but requires time for large tract dilation and days of sinus tract maturation to allow for a scope. We present a novel case of percutaneous digital cholangioscopy with SpyGlass DS, a small caliber scope traditionally used with endoscopic retrograde cholangiopancreatography, used for percutaneous transhepatic cholangioscopy after previous failed attempts by several different standard methods. Our case highlights a multidisciplinary approach in ultimately diagnosing malignancy.

Keywords: SpyGlass; biliary stricture; cholangioscopy.

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Figures

Figure 1.
Figure 1.
Magnetic resonance imaging showing intrahepatic ductal dilation with cutoff at the hilum and prominent perihilar soft tissue.
Figure 2.
Figure 2.
Image taken by a Spyglass cholangioscope of common bile duct stricture.
Figure 3.
Figure 3.
Spyglass cholangioscope advancing through percutaneous transhepatic cholangioscopy to obtain biopsies.
See this image and copyright information in PMC

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