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CC BY-NC-ND 4.0 · Endosc Int Open 2024; 12(08): E981-E988
DOI: 10.1055/a-2366-2265
Original article

Efficacy and safety of a single-use cholangioscope for percutaneous transhepatic cholangioscopy

Ivo Boskoski  ‡
1   Digestive Endoscopy Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
,
Torsten Beyna‡
2   Department of Internal Medicine, Evangelisches Krankenhaus Düsseldorf, Düsseldorf, Germany
,
James YW Lau
3   Surgery, The Chinese University of Hong Kong, New Territories, Hong Kong
,
Arnaud Lemmers 
4   Gastroenterology and Hepatology, Hôpital Erasme, Bruxelles, Belgium (Ringgold ID: RIN70496)
,
Mehran Fotoohi
5   Radiology, Virginia Mason Medical Center, Seattle, United States (Ringgold ID: RIN7289)
,
Mohan Ramchandani
6   Gastroenterology, Asian Institute of Gastroenterology, Hyderabad, India
,
Valerio Pontecorvi
1   Digestive Endoscopy Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
,
Joyce Peetermans
7   Endoscopy, Boston Scientific Corporation, Marlborough, United States
,
Eran Shlomovitz
8   Department of Surgery, Toronto General Hospital, Toronto, Canada (Ringgold ID: RIN33540)
› Author AffiliationsSupported by: Boston Scientific Corporation N/A

Clinical Trial: Registration number (trial ID): NCT04580940, Trial registry: ClinicalTrials.gov (http://www.clinicaltrials.gov/), Type of Study: Prospective, multicenter, multinational case series
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Abstract

Background and study aims Percutaneous transhepatic cholangioscopy (PTCS) is a management option for patients in whom peroral cholangioscopy or endoscopic retrograde cholangiopancreatography (ERCP) fail. We conducted a case series on the efficacy and safety of PTCS using a cholangiopancreatoscope cleared by the US Food and Drug Administration in 2020.

Patients and methods Fifty adult patients scheduled for PTCS or other cholangioscopic procedure were enrolled at seven academic medical centers and followed for 30 days after the index procedure. The primary efficacy endpoint was achievement of clinical intent by 30 days after the index PTCS procedure. Secondary endpoints included technical success, procedure time, endoscopist ratings of device attributes on a scale of 1 to 10 (best), and serious adverse events (SAEs) related to the device or procedure.

Results Patients had a mean age of 64.7±15.9 years, and 60.0% (30/50) were male. Forty-four patients (88.0%) achieved clinical intent by 30 days post-procedure. The most common reasons for the percutaneous approach were past (38.0%) or anticipated (30.0%) failed ERCP. The technical success rate was 96.0% (48/50), with a mean procedure time of 37.6 minutes (SD, 25.1; range 5.0–125.0). The endoscopist rated the overall ability of the cholangioscope to complete the procedure as a mean 9.2 (SD, 1.6; range 1.0–10.0). Two patients (4.0%) experienced related SAEs, one of whom had a fatal periprocedure aspiration.

Conclusions PTCS is an important endoscopic option for selected patients with impossible retrograde access or in whom ERCP fails. Because of the associated risk, this technique should be practiced by highly trained endoscopists at high-volume centers. (ClinicalTrials.gov number, NCT04580940)

Keywords

Pancreatobiliary (ERCP/PTCD) - Cholangioscopy - PTCD/PTCS - ERC topics


Publication History

Received: 30 January 2024

Accepted after revision: 10 July 2024

Accepted Manuscript online:
15 July 2024

Article published online:
23 August 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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