2024-02-28 01:00:51
[Chinese Health Network Article/Assistant Director of the Liver and Gastroenterology Department of Yadong Hospital Colin]Diagnostic methods for biliary tract and pancreatic diseases mainly rely on clinical physical examination, blood biochemical examination, imaging examination, etc. Ultrasound, computed tomography, and magnetic resonance imaging have brought the diagnosis of bile and pancreatic diseases to a higher level, and they have indeed provided considerable help to clinicians. However, sometimes endoscopic retrograde cholangiopancreatography (ERCP) and catheter-type cholangiopancreatoscopy are required to detect the more detailed structures of the biliary tract and pancreas, or to provide interventional diagnosis and treatment.
How do you know if biliary tract and pancreatic diseases are malignant?Catheter endoscopy goes deep into the bile and pancreas for precise diagnosis and treatment
What is Endoscopic Reverse Cholangiopancreatography (ERCP)
An endoscope (duodenoscope) is inserted through the mouth and passes through the esophagus, stomach, and to the second part of the duodenum. The catheter is then used to inject contrast agent into the bile duct and pancreatic duct to assess whether there are pathological changes in the bile duct and pancreatic duct. . If stones, strictures, and other lesions are present, the disease can be diagnosed and treated at the same time, or abnormal tissue samples can be obtained by sectioning.
Advantages and Disadvantages of Endoscopic Reverse Cholangiopancreatography (ERCP)
advantage
Small wound
Less pain
Less bleeding during surgery
Fast recovery following surgery
Short hospital stay
shortcoming
Only limited images and information can be provided. Unless the symptoms are obvious, mild, and the location is not complicated, it is difficult for doctors to diagnose at the first examination.
Difficult to provide precise location for biopsy
For patients whose common bile duct is filled with stones, or whose common bile duct stones are numerous and large in diameter, it is more difficult to remove the stones by ERCP.
What is “catheter cholangiopancreatoscopy”
Catheter-type cholangiopancreatoendoscope SpyGlass DS, as the name suggests, is an endoscopic system that can directly display (see) the bile duct and pancreatic duct, and can assist traditional endoscopic retrograde cholangiopancreatography (ERCP). It improves the limitations in diagnosis and treatment, improves the accuracy of lesion imaging position, accurately evaluates suspected benign and malignant diseases, and can be used to treat difficult stones and stenosis.
When is it necessary to evaluate ductal cholangiopancreatoscopy?
Unexplained bile and pancreatic duct lesions
Difficult to remove bile and pancreatic duct stones
Biopancreatic duct stenosis following liver transplantation or hepatobiliary surgery
Preoperative evaluation of biliopancreatic duct tumors
Others who are in need as assessed by professional physicians
Advantages of Catheter-type Cholangiopancreatoendoscopy (SpyGlass DS)
in diagnosis
It is used to supplement the shortcomings of existing endoscopic reverse cholangiopancreatography (ERCP). Direct-viewing bile duct and pancreatic duct endoscope (SpyGlass DS) can enter the human common bile duct, even the dilated liver duct, pancreatic duct, etc. In addition to seeing accurate images, it can also perform biopsy collection at the same time.
The sensitivity of endoscopic reverse cholangiopancreatography (ERCP) biopsy is regarding 20-30%, while the sensitivity of catheter-type cholangiopancreatoscopy (SpyGlass DS) can reach 78%, which is very important for early detection of patients. and correct diagnosis, both providing a more precise way.
in treatment
Currently, if endoscopic reverse cholangiopancreatography (ERCP) cannot remove large stones in the common bile duct, surgery or other methods will be required. Direct-viewing cholangiopancreatic endoscopy (SpyGlass DS) can be combined with endoscopic retrograde cholangiopancreatography (ERCP) to use laser or shock wave lithotripsy in the channel to break up and remove huge stones in the biliary tract. Prevent patients from needing surgery or other more invasive treatments. In addition to saving costs, it also reduces risks.
Catheter-type cholangiopancreatoendoscopy (SpyGlass DS) has many advantages. (Photo courtesy/Yadong Hospital)
What is the difference between the latest “ductal cholangiopancreatoscopy” and the traditional “retrograde cholangiopancreatography (ERCP)”
Traditional “retrograde cholangiopancreatography”
The lesions in the bile and pancreatic ducts are indirectly observed by injecting a contrast agent and developing it under radiation. According to the literature, the diagnostic accuracy of bile and pancreatic duct lesions is less than 50%. When large stones are encountered, surgery is the only option. In addition, post-operative stenosis treatment can only rely on extracorporeal percutaneous catheter drainage or surgery.
The latest “catheter-type cholangiopancreatic endoscopy”
Lesions in the bile and pancreatic ducts can be directly observed. According to the literature, the diagnostic accuracy of bile and pancreatic duct lesions is higher than 85%. Can treat large stones and replace surgery. In addition, post-operative stenosis treatment also has a high success rate.
in conclusion
In order to reduce the risk of surgery, there is currently a newly developed catheter-type cholangioendoscope system, which operates a thinner endoscope into the bile duct to directly visually observe the structure of the bile duct and the status of stones, and is equipped with a hydrophilic Sexual electric shock lithotripsy or laser lithotripsy can successfully break large and hard stones, helping more patients with bile duct stones that were difficult to treat in the past.
[Extended reading]
Source: Chinese Health Network
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