SpyGlass DS直视胆道镜系统在胆道疾病诊治中的初步临床研究(含视频）

Clinical value of SpyGlass DS digital cholangioscopy in diagnosis and treatment of patients with biliary tract diseases (with video)

摘要:

目的 探讨SpyGlass DS直视胆道镜系统在胆道疾病诊治中的临床应用价值。方法 使用SpyGlass DS直视胆道镜系统对7例胆道疾病患者（包括3例胆总管巨大结石，4例不明原因胆管狭窄）进行镜下诊断和治疗。对胆总管巨大结石患者，行SpyGlass DS胆道镜直视下激光碎石，继之行常规ERCP取石；对不明原因胆管狭窄患者，在SpyGlass DS胆道镜直视下观察病变情况，必要时取活检。结果 7例患者均成功完成SpyGlass DS镜下诊治， SpyGlass DS平均操作时间12.6 min。3例胆总管巨大结石患者均成功完成碎石及取石，术后3 d鼻胆管造影显示无结石残留。4例胆管狭窄患者中，2例镜下诊断为恶性胆管狭窄，并被活检病理证实；另外2例镜下诊断为炎性狭窄，未取活检。术后2例患者出现高淀粉酶血症，均自行恢复正常。结论 SpyGlass DS能成功用于难治性胆管结石及不明原因胆管狭窄患者的诊治。

Abstract:

Objective To evaluate the clinical application value of SpyGlass DS digital cholangioscopy in diagnosis and therapy of patients with biliary tract diseases. Methods Seven patients with biliary tract diseases were examined and treated with SpyGlass DS system. Three patients with large choledocholithiasis underwent laser lithotripsy, and then the broken stones were removed by ERCP. Four patients with indeterminate bile duct stricture underwent SpyGlass DS examination and SpyGlass DS-guided biopsies if necessary. Results SpyGlass DS cholangioscopy was successfully performed in all patients with a mean procedure time of 12.6 min. Complete stone clearance was achieved in all 3 patients with large biliary stones. Of the 4 patients with indeterminate biliary stricture, 2 underwent SpyGlass DS-guided biopsies and were diagnosed as malignant biliary tumor; the other 2 patients were diagnosed as inflammatory bile duct stenosis after visualizing the target lesions. Two patients developed hyperamylasemia after the procedure, and recovered spontaneously. Conclusion SpyGlass DS cholangioscopy can provide an accurate diagnosis in indeterminate biliary strictures and facilitate therapy in patients with challenging biliary stones.