Spyglass percutaneous transhepatic lithotripsy of symptomatic recurrent lithiasis of the intrahepatic bile duct with distal stenosis
Keywords:
bile duct diseases, biliary calculi, lithotripsyAbstract
In patients with symptomatic intrahepatic biliary lithiasis, the treatment is usually discussed by a multidisciplinary team. Although hepatectomy is considered as definitive treatment, when lobar atrophy is absent, endoscopic procedures are frequently proposed as first-line treatment due the low invasiveness and for sparing liver parenchyma. Percutaneous route is used in case of peroral approach failure. We present a case of recurrent symptomatic intrahepatic biliary lithiasis of the right posterior hepatic duct, sustained by downstream biliary stenosis. Peroral cholangioscopy failed to visualize the stone for the accompanying stenosis. Thus, the patient was successfully treated with percutaneous transhepatic lithotripsy performed with Spyglass direct visualization system II (Boston Scientific Inc., Natick, Massachusetts, USA). During the procedure, the biopsy of the biliary stenosis revealed fibrosis, which was treated by cholangioplasty with cutting balloon. After 15 months, the patient is asymptomatic, with moderate residual stenosis in absence of calculi at follow-up magnetic resonance cholangiography.
References
Lammert F, Acalovschi M, Ercolani G, van Erpecum KJ, Gurusamy KS, van Laarhoven CJ, et al. EASL Clinical Practice Guidelines on the prevention, diagnosis and treatment of gallstones. J Hepatol. 2016;65:146–181. PMID: 27085810.
Antypas P, Cereatti F, Donatelli G, Cappello A, Eberspacher C, Fanello G, et al. Sa1285 Spyglass©-guided electrohydraulic lithotripsy for intrahepatic and difficult common bile duct stones. a two-year experience in a single surgical tertiary center. Gastrointest Endosc 2018; 87:AB196.
Laleman W, Verraes K, Van Steenbergen W, Cassiman D, Nevens F, Van der Merwe S, et al. Usefulness of the single-operator cholangioscopy system SpyGlass in biliary disease: a single-center prospective cohort study and aggregated review. Surg Endosc. 2017;31:2223-2232. PMID: 27604370.
Oh HC, Lee SK, Lee TY, Kwon S, Lee SS, Seo DW, et al. Analysis of percutaneous transhepatic cholangioscopy-related complications and the risk factors for those complications. Endoscopy. 2007;39:731-736. PMID: 17661249.
Tripathi N, Mardini H, Koirala N, Raissi D, Emhmed Ali SM, Frandah WM. Assessing the utility, findings, and outcomes of percutaneous transhepatic cholangioscopy with SpyglassTM Direct visualization system: a case series. Transl Gastroenterol Hepatol. 2020;5:12. doi: 10.21037/tgh.2019.11.11. PMID: 32190780; PMCID: PMC7061197.
Hazey JW, McCreary M, Guy G, Melvin WS. Efficacy of percutaneous treatment of biliary tract calculi using the holmium:YAG laser. Surg Endosc. 2007;21:1180-1183. PMID: 17287911.
Huang M-H, Chen C-H, Yang J-C, Yang C-C, Yeh Y-H, Chou D-A, et al. Long-term outcome of percutaneous transhepatic cholangioscopic lithotomy for hepatolithiasis. Am J Gastroenterol. 2003;98:2655-2662. PMID: 14687812.
Righi D, Cesarani F, Muraro E, Gazzera C, Salizzoni M, Gandini G. Role of interventional radiology in the treatment of biliary strictures following orthotopic liver transplantation. Cardiovasc Intervent Radiol. 2002;25:30-35. PMID: 11907771.
Mukund A, Rajesh S, Agrawal N, Arora A, Arora A. Percutaneous management of resistant biliary-enteric anastomotic strictures with the use of a combined cutting and conventional balloon cholangioplasty protocol: a single-center experience. J Vasc Interv Radiol. 2015;26:560-565. PMID: 25666628.
Colombi D, Aragona G, Bodini FC, Zangrandi A, Morelli N, Michieletti E. SpyGlass percutaneous transhepatic cholangioscopy-guided diagnosis of adenocarcinoma of the ampullary region in a patient with bariatric biliopancreatic diversion. Hepatobiliary Pancreat Dis Int. 2019;18(3):291-293. PMID: 30879891.
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