Resumen

LANDAETA, Jorge et al. Experience colangioscopia peroral single operator (SPYGLASS) in biliary pathology in a center deprived of the third level in Venezuela.. Gen [online]. 2016, vol.70, n.2, pp.061-063. ISSN 2477-975X.

Spyglass is a disposable peroral cholangioscope monoperator that has been available since early 2007 for biliary disease. Objective: To demonstrate the experience in Venezuela using Spyglass system in patients with biliary disease. Patients and Methods: Prospective study (february2012-may2015), Polyclinic Metropolitana.50 spyglass were performed, representing 7.7% of the volume of bile ERCP in the same period (50/650). 46 patients (45 males, 1 female), mean age 62.6 years (24-92 years) were included. Indications: choledocholithiasis (20), stenosis (23), tumor (2), dicard neo between two prothesis (1), trans prosthesis stent (1) .A monoperator through a therapeutic duodenoscope made cholangioscopy spyglass. Sedation for anesthesiology and prophylactic antibiotic was administered. Results: Spyglass was performed in 46 patients (50 procedures) .Findings: lithiasis (20 patients), benign stricture (10), malignant stricture (13), sclerosing cholangitis (1), trans prosthesis stent (1). Of patients with stone disease, ductal clearance holmium laser after lithotripsy was achieved in 85% after a session, and 15% in a second attempt.Spyglass confirmed the diagnosis of malignancy in 13/21 (62%), the diagnosis was established by combination of visual features and directs biopsies.En 7/21 (33.33%) change diagnosis: benign (6), sclerosing cholangitis (1) and one diagnosis could not be established. The suspicion was confirmed benignity in 3/4 patients. Pancreatitis, retroperitoneal microperforation and pancreatic fistula was reported in one patient (2.17%) resolved with medical and surgical treatment. Conclusions: Spyglass is a useful technique for suspected benign or malignant stricture, diagnosis differed modifying behavior. Spyglass is a useful adjuvant to ERCP in the management of difficult stone disease.

Palabras clave : cholangioscopy single operator; spyglass; biliary disease; benign stricture; malignant stricture; lithiasis.