The clinical value of ERCP-guided cholangiopancreatoscopy using a singleoperator system
Date
2019
Journal Title
Journal ISSN
Volume Title
Publisher
BioMed Central
Abstract
Background: Single-operator, per-oral cholangiopancreatoscopy (SOPCP) enables direct biliopancreatic ductal
visualization, targeted tissue sampling, and therapeutic intervention. At Karolinska University Hospital, SOPCP was
introduced early and has since been extensively utilized according to a standardized protocol. We analysed the
clinical value of SOPCP in the diagnosis and treatment of biliopancreatic diseases in a single high volume center.
Methods: All SOPCP procedures performed between March 2007 and December 2014 were retrospectively reviewed.
Each procedure’s diagnostic yield and therapeutic value was evaluated using a predefined 4 grade scale; 1 - no diagnostic
or therapeutic value, 2 - information gained did not impact clinical decision-making and in case of a therapeutic
intervention, did not alter the clinical course of the patient, 3 - information gained had an impact on clinical
decision-making and in the case of a therapeutic intervention, assisted subsequent disease management, and
finally, 4 - information gained was essential and critical for clinical decision-making and in case of a therapeutic
intervention, solved the clinical problem requiring no further therapeutic actions. Descriptive statistics were used
to analyse results, with uni- and multivariate analyses completed to assess risk of adverse events.
Results: During the study period, 365 SOPCP procedures were performed. We found SOPCP of pivotal importance
(grade 4) in 19% of cases, and of great clinical significance (grade 3) in 44% of cases. SOPCP did not affect clinical
decision-making or alter clinical course (grade 1 and 2) in 37% of cases.
Conclusion: SOPCP offers direct access to the biliopancreatic ducts for both diagnostic and therapeutic purposes, adding
significant clinical value in 64% of cases.
Description
CITATION: Reuterwall, M. et al. 2019. The clinical value of ERCP-guided cholangiopancreatoscopy using a singleoperator system. BMC Gastroenterology, 19:35, doi:10.1186/s12876-019-0953-9.
The original publication is available at https://bmcgastroenterol.biomedcentral.com
The original publication is available at https://bmcgastroenterol.biomedcentral.com
Keywords
Cholangiopancreatoscopy, Pancreatic duct, Bile ducts, Bile ducts -- Examination, Bile ducts -- Surgery
Citation
Reuterwall, M. et al. 2019. The clinical value of ERCP-guided cholangiopancreatoscopy using a singleoperator system. BMC Gastroenterology, 19:35, doi:10.1186/s12876-019-0953-9.