Novel application of SpyGlass™ cholangioscopy in the diagnosis and treatment of extrahepatic biliary obstruction in infants
Endoscopic retrograde cholangiopancreatography (ERCP) is a commonly utilized diagnostic and therapeutic modality for the treatment of obstructive extrahepatic biliary disease. In toddlers and infants ERCP is challenging and limited by the size of the common bile duct, reliance on fluoroscopy for bil...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2018-11-01
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| Series: | Journal of Pediatric Surgery Case Reports |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2213576618301556 |
| _version_ | 1828813003470929920 |
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| author | Kathryn J. Rowland Aaron J. Cunningham Saad F. Jazrawi Ronald Prauner Marilyn W. Butler Mubeen Jafri |
| author_facet | Kathryn J. Rowland Aaron J. Cunningham Saad F. Jazrawi Ronald Prauner Marilyn W. Butler Mubeen Jafri |
| author_sort | Kathryn J. Rowland |
| collection | DOAJ |
| description | Endoscopic retrograde cholangiopancreatography (ERCP) is a commonly utilized diagnostic and therapeutic modality for the treatment of obstructive extrahepatic biliary disease. In toddlers and infants ERCP is challenging and limited by the size of the common bile duct, reliance on fluoroscopy for bile duct cannulation, and indirect visualization of the bile duct via radiography. The SpyGlass™ cholangioscope (10 Fr, Boston Scientific) allows for direct visualization of bile duct pathology and enables targeted tissue biopsies within the bile duct. Case report: SpyGlass™ cholangioscopy was performed to diagnose, monitor, and therapeutically stent an embryonal rhabdomyosarcoma of the common bile duct in an 18-month-old girl who initially presented with jaundice. Initial ERCP brushings of the common bile duct proved non-diagnostic in this patient. Use of SpyGlass™ cholangioscopy allowed for visualization of the biliary mass and targeted biopsies, confirming embryonal rhabdomyosarcoma and defining the extent of disease in the right and left hepatic ducts. The child was treated with chemotherapy and radiation therapy with subsequent biopsies that have demonstrated no active disease. Conclusions: SpyGlass™ cholangioscopy is a valuable tool in the diagnosis and treatment of biliary obstructive lesions and can be utilized in children under the age of 2 with success. Keywords: Cholangioscopy, SpyGlass™, Pediatric |
| first_indexed | 2024-12-12T09:52:59Z |
| format | Article |
| id | doaj.art-67984e8ce3e84f98bec0fb914895c6fe |
| institution | Directory Open Access Journal |
| issn | 2213-5766 |
| language | English |
| last_indexed | 2024-12-12T09:52:59Z |
| publishDate | 2018-11-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Pediatric Surgery Case Reports |
| spelling | doaj.art-67984e8ce3e84f98bec0fb914895c6fe2022-12-22T00:28:13ZengElsevierJournal of Pediatric Surgery Case Reports2213-57662018-11-01381922Novel application of SpyGlass™ cholangioscopy in the diagnosis and treatment of extrahepatic biliary obstruction in infantsKathryn J. Rowland0Aaron J. Cunningham1Saad F. Jazrawi2Ronald Prauner3Marilyn W. Butler4Mubeen Jafri5Division of Pediatric Surgery, Department of Surgery, Oregon Health and Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239, USADivision of Pediatric Surgery, Department of Surgery, Oregon Health and Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239, USANorthwest Gastroenterology Clinic, 501 North Graham Street, Portland, OR 97227, USAPediatric Hematology-Oncology, Randall Children's Hospital at Legacy Emanuel, 501 North Graham Street, Portland, OR 97227, USADivision of Pediatric Surgery, Department of Surgery, Oregon Health and Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239, USA; Pediatric Surgery, Randall Children's Hospital at Legacy Emanuel, 501 North Graham Street, Portland, OR 97227, USADivision of Pediatric Surgery, Department of Surgery, Oregon Health and Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239, USA; Pediatric Surgery, Randall Children's Hospital at Legacy Emanuel, 501 North Graham Street, Portland, OR 97227, USA; Corresponding author. 501 N. Graham St., Suite 300, Portland, OR 97227, USA.Endoscopic retrograde cholangiopancreatography (ERCP) is a commonly utilized diagnostic and therapeutic modality for the treatment of obstructive extrahepatic biliary disease. In toddlers and infants ERCP is challenging and limited by the size of the common bile duct, reliance on fluoroscopy for bile duct cannulation, and indirect visualization of the bile duct via radiography. The SpyGlass™ cholangioscope (10 Fr, Boston Scientific) allows for direct visualization of bile duct pathology and enables targeted tissue biopsies within the bile duct. Case report: SpyGlass™ cholangioscopy was performed to diagnose, monitor, and therapeutically stent an embryonal rhabdomyosarcoma of the common bile duct in an 18-month-old girl who initially presented with jaundice. Initial ERCP brushings of the common bile duct proved non-diagnostic in this patient. Use of SpyGlass™ cholangioscopy allowed for visualization of the biliary mass and targeted biopsies, confirming embryonal rhabdomyosarcoma and defining the extent of disease in the right and left hepatic ducts. The child was treated with chemotherapy and radiation therapy with subsequent biopsies that have demonstrated no active disease. Conclusions: SpyGlass™ cholangioscopy is a valuable tool in the diagnosis and treatment of biliary obstructive lesions and can be utilized in children under the age of 2 with success. Keywords: Cholangioscopy, SpyGlass™, Pediatrichttp://www.sciencedirect.com/science/article/pii/S2213576618301556 |
| spellingShingle | Kathryn J. Rowland Aaron J. Cunningham Saad F. Jazrawi Ronald Prauner Marilyn W. Butler Mubeen Jafri Novel application of SpyGlass™ cholangioscopy in the diagnosis and treatment of extrahepatic biliary obstruction in infants Journal of Pediatric Surgery Case Reports |
| title | Novel application of SpyGlass™ cholangioscopy in the diagnosis and treatment of extrahepatic biliary obstruction in infants |
| title_full | Novel application of SpyGlass™ cholangioscopy in the diagnosis and treatment of extrahepatic biliary obstruction in infants |
| title_fullStr | Novel application of SpyGlass™ cholangioscopy in the diagnosis and treatment of extrahepatic biliary obstruction in infants |
| title_full_unstemmed | Novel application of SpyGlass™ cholangioscopy in the diagnosis and treatment of extrahepatic biliary obstruction in infants |
| title_short | Novel application of SpyGlass™ cholangioscopy in the diagnosis and treatment of extrahepatic biliary obstruction in infants |
| title_sort | novel application of spyglass™ cholangioscopy in the diagnosis and treatment of extrahepatic biliary obstruction in infants |
| url | http://www.sciencedirect.com/science/article/pii/S2213576618301556 |
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