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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
.
Diseases
Validation
Diseases presenting
"pancreatitis"
symptom
benign recurrent intrahepatic cholestasis
carcinoma of the gallbladder
cholangiocarcinoma
cystinuria
dracunculiasis
familial hypocalciuric hypercalcemia
scrub typhus
systemic capillary leak syndrome
This symptom has already been validated