Single-operator cholangiopancreatoscopy in pancreatobiliary diseases: clinical experience in a tertiary referral hospital.

Background and Aims: to assess the usefulness, efficacy and safety of single-operator cholangiopancreatoscopy (SOCP) with the SpyGlass™ system for the management of biliopancreatic diseases.
Methods: a retrospective analysis of patients undergoing SOCP with the SpyGlass™ between September 2008 and April 2016 was performed. Data was obtained from a prospectively-maintained database at a tertiary referral center. The primary study outcomes were technical and complete endoscopic success of the procedure. Two different SpyGlass™ systems were employed; the former is called legacy and the latter, digital system (DS).
Results: a total of 107 SOCP procedures in 93 patients performed by a single operator were analyzed. Technical success of the SpyGlass™ examination was achieved in 90/93 (97%) of patients and complete success by resolving the biliopancreatic condition in 82/93 (88%) cases. In indeterminate biliary strictures, a complete success was achieved in 45/52 (85%) of cases. With regard to stone treatment, technical success was achieved in 34/34 (100%) patients and complete success, in 31/34 (91%) cases. Electrohydraulic lithotripsy was applied in 16/34 (47%) of cases. There were a total of 7/93 adverse effects (7.5%).
Conclusions: SOCP is a useful and safe technique for the treatment of biliopancreatic diseases with a low rate of adverse effects. The procedure seems technically demanding and dedication is required.