Safety of a novel domestic direct visualization system of peroral cholangiopancreatoscopy for biliary tract exploration
10.3760/cma.j.cn321463-20240516-00359
- VernacularTitle:新型国产经口胆胰直视化子镜系统用于胆道探查的安全性
- Author:
Jingyi LIU
1
;
Zhipeng QI
;
Jiawei ZHANG
;
Dongli HE
;
Zhanghan CHEN
;
Yirong CHENG
;
Jieling JIANG
;
Yan TANG
;
Jiachen JING
;
Yunshi ZHONG
;
Pinxiang LU
Author Information
1. 上海市徐汇区中心医院 复旦大学附属中山医院徐汇医院内镜中心，上海 200030
- Publication Type:Journal Article
- Keywords:
Cholangiopancreatography, endoscopic retrograde;
Biliary tract diseases;
Pancreatitis;
Safety;
Peroral direct view choledochoscope
- From:
Chinese Journal of Digestive Endoscopy
2025;42(1):28-33
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To assess the safety of a novel domestically developed direct visualization system of peroral cholangiopancreatoscopy for the exploration of biliary tract.Methods:Clinical data from 384 patients with biliary tract diseases who underwent endoscopic retrograde cholangiopancreatography (ERCP) at the Endoscopy Center of Shanghai Xuhui District Central Hospital from November 2017 to December 2022 were retrospectively analyzed. Patients were categorized into 2 groups based on the type of cholangioscope: the novel cholangiopancreatoscopy system group ( n=159) and the SpyGlass group ( n=225). In the novel cholangiopancreatoscopy system group, the new direct visualization system of China-made peroral cholangiopancreatoscopy was used for bile duct exploration, while the SpyGlass group utilized the SpyGlass system for bile duct inspection. Propensity score matching (PSM) was used as a nearest-neighbor method with a caliper of 0.01 to minimize confounding factors, resulting in a balanced sample of 122 patients in each group after matching. The primary outcome was the incidence of short-term complications, with secondary outcomes including technical success rates and post-treatment outcomes. Results:After PSM, there were no significant differences in baseline characteristics between the two groups ( P>0.05). Regarding short-term postoperative complications, pancreatitis occurred in 1.6% (2/122) of patients in the novel cholangiopancreatoscopy system group and 7.4% (9/122) in the SpyGlass group. The new system significantly reduced the incidence of post-procedure pancreatitis ( χ2=4.665, P=0.031). The cholecystitis was absent in the novel cholangiopancreatoscopy system group, while it occurred in 0.8% (1/122) cases in the SpyGlass group, with no significant difference between the two groups after the procedure ( P=1.000). Regarding technical success rate, the novel system group achieved a rate of 99.2% (121/122), while the SpyGlass group achieved 97.5% (119/122) ( P=0.622). A slightly higher success rate was observed in the novel system group.There were 81 cases of postoperative biliary drainage in the novel cholangiopancreatoscopy system group and 74 cases in the SpyGlass group. Conclusion:The novel direct visualization system of peroral cholangiopancreatoscopy is safer than SpyGlass in the exploration of biliary system diseases. Endoscopists are encouraged to choose the appropriate cholangioscopy system based on individual patient characteristics for the direct visualization, diagnosis, and treatment of biliary diseases.
