An International Experience with Single-operator Cholangiopancreatoscopy in Patients with Altered Anatomy

Overview

Journal Endosc Int Open

Specialty Gastroenterology

Date 2022 Jun 13

PMID 35692911

Authors

Shruti Mony

Bachir Ghandour

Isaac Raijman

Amar Manvar

Sammy Ho

Arvind J Trindade

Petros C Benias

Claudio Zulli

Jeremie Jacques

Yervant Ichkhanian

Tobias Zuchelli

Mouhanna Abu Ghanimeh

Shayan Irani

Andrew Canakis

Omid Sanaei

Daniel Szvarca

Linda Zhang

Michael Bejjani

Venkata Akshintala

Mouen A Khashab

Affiliations

Soon will be listed here.

Abstract

The utility of digital single- operator cholangiopancreatoscopy (D-SOCP) in surgically altered anatomy (SAA) is limited. We aimed to evaluate the technical success and safety of D-SOCP in patients SAA. Patients with SAA who underwent D-SOCP between February 2015 and June 2020 were retrospectively evaluated. Technical success was defined as completing the intended procedure with the use of D-SOCP. Thirty-five patients underwent D-SOCP (34 D-SOC, 1 D-SOP). Bilroth II was the most common type of SAA (45.7 %), followed by Whipple reconstruction (31.4 %). Twenty-three patients (65.7 %) patients had prior failed ERCP due to the presence of complex biliary stone (52.2 %). A therapeutic duodenoscope was utilized in the majority of the cases (68.6 %), while a therapeutic gastroscope (22.7 %) or adult colonoscope (8.5 %) were used in the remaining procedures. Choledocholithiasis (61.2 %) and pancreatic duct calculi (3.2 %) were the most common indications for D-SOCP. Technical success was achieved in all 35 patients (100 %) and majority (91.4 %) requiring a single session. Complex interventions included electrohydraulic or laser lithotripsy, biliary or pancreatic stent placement, stricture dilation, and target tissue biopsies. Two mild adverse events occurred (pancreatitis and transient bacteremia). In SAA, D-SOCP is a safe and effective modality to diagnose and treat complex pancreatobiliary disorders, especially in cases where standard ERCP attempts may fail.

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