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Written Case Studies & Articles

 

Compelling Clinical Data Presented on Cholangioscopy at Digestive Disease Week™

Physicians share feedback regarding the abstract data they presented at DDW 2016.

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Using Cholangioscopy to Provide a Diagnosis of Benign Hepatobiliary Cystadenoma Presented by Abhijit Kulkarni M.D. FASGE

A 68-year-old Caucasian female with a past medical history of cholelithiasis presented to us with right upper quadrant pain and intermittent dark urine. A CT scan showed a thin walled cystic lesion encompassing almost the entire caudate lobe. ERCP using cholangioscopy was then performed to determine the nature of this obstruction.

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Providing a Definitive Diagnosis of Cholangiocarcinoma for a Patient who Underwent 4 Failed Diagnostic Tests, presented by Dr. Khosravi, Dr. Sachdev and Dr. Das

A 64-year-old female was diagnosed with a hilar mass, causing suspicion of cholangiocarcinoma. After undergoing 4 failed diagnostic tests, addition, cholangioscopy with biopsy using the SpyGlass™ DS System and SpyBite™ Biopsy Forceps was recommended to aid in establishing a diagnosis.

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Using Cholangioscopy to Fragment a Difficult Stone in a Patient who had 17 Previous ERCPs by Mary Lee Krinsky, D.O.

An 81-year-old man with a history of recurrent choledocholithiasis presented to the hospital with cholangitis after undergoing 17 previous ERCPs. The patient had a large stone at the bifurcation of the biliary tree and attempts at mechanical lithotripsy failed to achieve complete removal. The patient then underwent ERCP with cholangioscopy, using the SpyGlass DS System.

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Diagnosis and Treatment of Biliary Duct Lesions: First Report from Latin America, Carlos Robles-Medranda, MD and Roberto Gugig, MD.

In this case, we treated a 81-year-old female patient with a large common bile duct stone > 2 cm, who had undergone a previous endoscopic retrograde cholangiopancreatography (ERCP), with plastic stent placement (10 Fr by 10 cm), and who returned 3 months later for electrohydraulic lithotripsy.

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SpyGlass™ DS System: Bringing a Sharper Focus to Cholangioscopy

DS = Digital + Simple. Read about how the first single operator cholangioscopy system has been re-engineered with digital imaging, a wider field of view and a simpler ‘plug and play’ set-up. Physicians share early feedback on the new digital system.

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Distinguishing Etiology of Biliary Stricture Using the SpyGlass™ DS System by Ajay Jain, M.D.

An 82-year-old female with a history of chronic atrial fibrillation on coumadin was directly admitted with a supratherapeutic INR >13. She was found to have increased LFTs and RUQ US findings of biliary ductal dilation with gallbladder sludge. A CT scan of the abdomen revealed biliary dilation and findings suggestive of chronic pancreatitis. In an effort to determine the nature of the biliary obstruction, the patient was set up for an ERCP with cholangioscopy.

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Using the SpyGlass™ DS Direct Visualization System to Help in Precise Diagnosis and Staging of Cholangiocarcinoma, Presented by Neil R. Sharma, M.D.

A 71-year-old male presented with one week of itching, jaundice and dark urine. He did not report having abdominal pain, but did have some mild abdominal cramping with bowel movements. His stools became light in color, but otherwise no change in his bowel movements. He did not experience weight loss, nausea, or vomiting. His mother died of liver cancer at age 63. No family history of pancreatic diseas

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Diagnosing Distal Cholangiocarcinoma with Extension to Right Hepatic Duct using the SpyGlass™ DS System, Presented by Isaac Raijman, M.D.

Dr. Raijman performs cholangioscopy using the SpyGlass DS System to assess the local intraductal extent of a tumor in the distal CBD as well as a mild narrowing in the RHD. Targeted biopsies under direct visualization revealed adenocarcinoma in the RHD, the same as found distally. It was determined that this patient was not a candidate for surgery, saving unnecessary risk to the patient and cost to the hospital system.

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