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Bimodal ERCP, a new way of seeing things
- Source :
- Endoscopy International Open, Vol 08, Iss 03, Pp E368-E376 (2020), Endoscopy International Open
- Publication Year :
- 2020
- Publisher :
- Georg Thieme Verlag KG, 2020.
-
Abstract
- Background and study aims Conventional endoscopic retrograde cholangiopancreatography (ERCP) is hampered by two-dimensional visualization, post-procedural adverse events (AEs), and exposure to ionizing radiation. Bimodal ERCP might mitigate these challenges, but no reports of its use are available to date. The aim of this study was to explore the feasibility of bimodal ERCP, while investigating its potential clinical yield. Patients and methods This was a retrospective observational study of patients that underwent bimodal ERCP in a single tertiary academic referral center. Thirteen patients undergoing conventional ERCP had a previously T2-weighted isotropic 3 D TSE MRCP sequence aligned and fused with the two-dimensional image generated from the fluoroscopy c-arm unit in real time. Results Over a 2-month period, 13 patients with a mean age of 54 underwent bimodal ERCP for bile duct stricture (61.5 %), complex cholelithiasis (7.7 %) and ductal leakage (30.1 %). Bimodal ERCP was feasible in all 13 cases, and image quality was assessed as “good” in 11 patients (84.6 %). Bimodal ERCP aided in visualizing the lesion of interest (76.9 %), assisted in understanding the 3 D anatomy of the biliopancreatic ductal system (61.5 %), and aided in finding a favorable position for the c-arm (38.4 %) for subsequent therapeutic intervention. Conclusions This first report on bimodal ERCP proves its feasibility and suggests that it may assist in increasing both the diagnostic and therapeutic yield of ERCP, while at the same time decreasing AEs during and after ERCP. Its main application might lie in treatment of complex intrahepatic disease.
- Subjects :
- medicine.medical_specialty
Original article
Endoscopic retrograde cholangiopancreatography
medicine.diagnostic_test
business.industry
Bile duct
Mean age
Retrospective cohort study
digestive system
digestive system diseases
03 medical and health sciences
0302 clinical medicine
medicine.anatomical_structure
surgical procedures, operative
030220 oncology & carcinogenesis
Medicine
Fluoroscopy
Referral center
030211 gastroenterology & hepatology
Pharmacology (medical)
lcsh:Diseases of the digestive system. Gastroenterology
Radiology
lcsh:RC799-869
business
Adverse effect
Subjects
Details
- Language :
- English
- ISSN :
- 21969736 and 23643722
- Issue :
- 03
- Database :
- OpenAIRE
- Journal :
- Endoscopy International Open
- Accession number :
- edsair.doi.dedup.....492a47e10956e7ccd45ff810ac91575c