Endoscopy
DOI: 10.1055/a-2387-9170
Innovations and brief communications
Wengang Zhang‡
1
Department of Gastroenterology, The First Medical Center of Chinese PLA General Hospital, Beijing, China
,
1
Department of Gastroenterology, The First Medical Center of Chinese PLA General Hospital, Beijing, China
,
Bozong Shao
1
Department of Gastroenterology, The First Medical Center of Chinese PLA General Hospital, Beijing, China
,
Jiafeng Wang
1
Department of Gastroenterology, The First Medical Center of Chinese PLA General Hospital, Beijing, China
,
Qingzhen Wu
1
Department of Gastroenterology, The First Medical Center of Chinese PLA General Hospital, Beijing, China
,
Ningli Chai
1
Department of Gastroenterology, The First Medical Center of Chinese PLA General Hospital, Beijing, China
,
1
Department of Gastroenterology, The First Medical Center of Chinese PLA General Hospital, Beijing, China
› Author AffiliationsSupported by:
Chinese PLA General Hospital Young Independent Innovation Science Fund
22QNFC072
Clinical Trial: Registration number (trial ID): ChiCTR2200063675, Trial registry: Chinese Clinical Trial Registry (http://www.chictr.org/), Type of Study: Prospective study
› Further Information
Also available at
![SFX Search]()
Buy Article Permissions and Reprints
Abstract
Background This study aimed to assess the feasibility and safety of performing cholangiopancreatoscopy-assisted endoscopic mucosal resection (CA-EMR) for biliopancreatic intraductal lesions.
Methods Special electrocautery snares and injection needles that can pass through the working channel of a single-operator cholangiopancreatoscope were developed. Between November 2023 and April 2024, we performed CA-EMR for two patients with gallbladder polyps, one patient with a neoplastic lesion in the common bile duct (CBD), and one patient with a neoplastic lesion in the main pancreatic duct. The technical success rate and adverse events were recorded.
Results All four CA-EMR procedures were performed successfully. Postoperative pathology revealed inflammatory gallbladder polyps in two patients, low grade intraepithelial neoplasia of the CBD in one patient, and intraductal papillary mucinous neoplasm (IPMN) in one patient. The patient with IPMN experienced mild postoperative pancreatitis and recovered after conservative treatment. No adverse events were encountered in the other three CA-EMR procedures.
Conclusion This study preliminarily confirmed the feasibility and safety of CA-EMR for treating biliopancreatic intraductal lesions.
Publication History
Received: 01 May 2024
Accepted after revision: 14 August 2024
Accepted Manuscript online:
14 August 2024
Article published online:
18 October 2024
© 2024. Thieme. All rights reserved.
Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany
References
1
Shin IS,
Moon JH,
Lee YN.
et al.
Use of peroral cholangioscopy to screen for neoplastic bile duct lesions in patients with bile duct stones (with videos). Gastrointest Endosc 2021; 94: 776-785
2
Politano SA,
Hamiduzzaman N,
Alhaqqan D.
Diseases of the gallbladder and biliary tree. Prim Care 2023; 50: 377-390 DOI:
10.1016/j.pop.2023.03.004. (PMID:
37516509)
3
de Jong DM,
Stassen PMC,
Groot Koerkamp B.
et al.
The role of pancreatoscopy in the diagnostic work-up of intraductal papillary mucinous neoplasms: a systematic review and meta-analysis. Endoscopy 2023; 55: 25-35
4
Zhang WG,
Chai NL,
Zhang B.
et al.
Cholangioscopy-assisted extraction through novel papillary support for small-calibre and sediment-like common bile duct stones. World J Gastroenterol 2023; 29: 2495-2501
5
Zhang W,
Chai N,
Zhai Y.
et al.
Cholangioscopy-assisted extraction of choledocholithiasis and partial sediment-like gallstones through papillary support: a pilot exploration for super minimally invasive surgery. Endoscopy 2023; 55: E274-e275
6
Zhang W,
Chai N,
Feng Y.
et al.
Cholangioscopy-assisted endoscopic mucosal resection for a mildly dysplastic lesion of the common bile duct: a pilot exploration for super minimally invasive surgery. Endoscopy 2024; 56: E166-e167 DOI:
10.1055/a-2257-3531. (PMID:
38359893)
7
Yokoe M,
Hata J,
Takada T.
et al.
Tokyo Guidelines 2018: diagnostic criteria and severity grading of acute cholecystitis (with videos). J Hepatobiliary Pancreat Sci 2018; 25: 41-54
8
Cotton PB,
Lehman G,
Vennes J.
et al.
Endoscopic sphincterotomy complications and their management: an attempt at consensus. Gastrointest Endosc 1991; 37: 383-393
9
Qandeel H,
Nassar AHM,
Ng HJ.
et al.
Laparoscopic cholecystectomy for gallbladder dysfunction and polyps: incidence and follow up. JSLS 2021; 25: e2021.00009
10
Griffin JF,
Poruk KE,
Wolfgang CL.
Is it time to expand the role of total pancreatectomy for IPMN?. Dig Surg 2016; 33: 335-342 DOI:
10.1159/000445019. (PMID:
27215900)
11
Cillo U,
Fondevila C,
Donadon M.
et al.
Surgery for cholangiocarcinoma. Liver Int 2019; 39: 143-155 DOI:
10.1111/liv.14089. (PMID:
30843343)
12
Parkman HP,
Yates K,
Hasler WL.
et al.
Cholecystectomy and clinical presentations of gastroparesis. Dig Dis Sci 2013; 58: 1062-1073 DOI:
10.1007/s10620-013-2596-y. (PMID:
23456496)
13
Kang Z,
Lu M,
Jiang M.
et al.
Proteobacteria acts as a pathogenic risk-factor for chronic abdominal pain and diarrhea in post-cholecystectomy syndrome patients: a gut microbiome metabolomics study. Med Sci Monit 2019; 25: 7312-7320 DOI:
10.12659/MSM.915984. (PMID:
31563920)
14
Zhang J,
Lu Q,
Ren YF.
et al.
Factors relevant to persistent upper abdominal pain after cholecystectomy. HPB (Oxford) 2017; 19: 629-637 DOI:
10.1016/j.hpb.2017.04.003. (PMID:
28495436)
15
Li Q,
Tao L,
Wu X.
et al.
Bile duct stone formation around a Prolene suture after cholangioenterostomy. Pak J Med Sci 2016; 32: 263-266 DOI:
10.12669/pjms.321.8985. (PMID:
27022388)
16
Zhang W,
Chai N,
Zhang B.
et al.
Cholangioscopy-assisted endoscopic mucosal resection for bile duct lesions through papillary support: a pilot exploration for super minimally invasive surgery in a porcine model. Endoscopy 2023; 55: E1230-e1231
17
Zen Y,
Akita M.
Neoplastic progression in intraductal papillary neoplasm of the bile duct. Arch Pathol Lab Med 2024; 148: 989-996 DOI:
10.5858/arpa.2022-0407-RA. (PMID:
36800543)
18
Serra S.
Precursor neoplastic lesions of the biliary tract. J Clin Pathol 2014; 67: 875-882 DOI:
10.1136/jclinpath-2014-202435. (PMID:
25004942)
19
Nista EC,
Schepis T,
Candelli M.
et al.
Humoral predictors of malignancy in IPMN: a review of the literature. Int J Mol Sci 2021; 22: 12839 DOI:
10.3390/ijms222312839. (PMID:
34884643)
20
Wiles R,
Varadpande M,
Muly S.
et al.
Growth rate and malignant potential of small gallbladder polyps – systematic review of evidence. Surgeon 2014; 12: 221-226 DOI:
10.1016/j.surge.2014.01.003. (PMID:
24502936)
留言 (0)