Rare Diseases Symptoms Automatic Extraction
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Spyglass single-operator peroral cholangioscopy seems promising in the evaluation of primary sclerosing cholangitis-related biliary strictures.
[cholangiocarcinoma]
Abstract
Early
diagnosis
of
dysplastic
changes
and
exclusion
of
cholangiocarcinoma
(
CCA
)
in
patients
with
primary
sclerosing
cholangitis
(
PSC
)
remain
a
major
clinical
challenge
.
Although
SpyGlass
single
-operator
cholangioscopy
(
SOC
)
appears
effective
in
diagnostics
of
indeterminate
biliary
strictures
,
there
are
only
few
studies
on
its
safety
in
PSC
-related
strictures
.
Objective
.
The
aim
of
this
study
was
to
assess
the
clinical
feasibility
of
SOC
and
directed
biopsies
,
flow
cytometry
,
and
brush
cytology
in
PSC
patients
.
Materials
and
methods
.
Eleven
consecutive
patients
(
median
age
45
years
,
5
females
)
undergoing
SOC
for
progression
of
PSC
in
a
single
tertiary
center
were
included
in
a
prospective
observational
study
.
Results
.
Brush
sample
and
directed
biopsies
were
successfully
acquired
from
strictures
in
all
cases
.
Samples
were
adequate
for
cytological
and
histological
diagnosis
in
9
(
82
%
)
and
10
patients
(
91
%
)
,
respectively
.
There
were
two
cases
of
pancreatitis
.
In
one
patient
,
flow
cytometry
showed
aneuploidy
,
which
resulted
in
closer
follow-up
.
Conclusions
.
SpyGlass
SOC
and
directed
biopsies
seem
to
offer
a
feasible
and
promising
method
in
evaluation
of
PSC
-related
strictures
.
However
,
the
long
-term
prognostic
value
it
adds
to
cytology
and
flow
cytometry
remains
to
be
assessed
in
future
trials
.