SpyGlass直视化系统在胆管疾病诊断和治疗中的应用*

Application of SpyGlass Direct Visualization System in diagnosis and treatment of biliary diseases*

摘要:

摘要：目的 评估SpyGlass直视化系统在不明性质胆管疾病诊断以及复杂胆管结石治疗中的效果。方法 回顾性分析2015年1月－2017年12月该中心采用SpyGlass直视化系统诊断和治疗的连续108例胆管疾病患者的临床资料。SpyGlass直视化系统诊断和治疗的措施包括：SpyGlass直视化系统检查，SpyGlass直视化系统引导下活检和SpyGlass直视化系统取石。SpyGlass直视化系统诊断及治疗成功的评价指标包括：目标病变充足的可视化，SpyGlass直视化系统引导下完成充足的组织取样，以及结石的彻底清除。结果 共计108例患者纳入该研究，76（70.4%）应用SpyGlass直视化系统进行诊断，32例（29.6%）行结石的治疗。诊断及治疗总成功率89.8%（97/108）；其中68例顺利通过SpyGlass直视化系统完成诊断，诊断成功率89.5%（68/76）；29例在SpyGlass直视化系统引导下完成结石的彻底清除，治疗成功率90.6%（29/32）；并发症发生率10.2%（11/108）。结论 SpyGlass直视化系统通过到达病变组织进行直视化观察和充足取样，提高了不明性质胆管病变诊断的准确率，同时SpyGlass直视化系统联合各种取石、碎石设备直视下清除结石，提高了复杂胆管结石治疗的成功率。

Abstract:

Abstract: Objective To evaluate the effect of SpyGlass Direct Visualization System (SGDVS) in diagnosis of indeterminate biliary lesions and the treatment of complex bile duct stones. Methods The clinical data of 108 consecutive patients who underwent SGDVS for diagnosis or treatment between January 2015 and December 2017 was retrospectively reviewed. The measures of SGDVS diagnosis and treatment include: for detecting indeterminate biliary lesions, SpyGlass-guided biopsy and stones removal. The main outcomes were related to the procedure in terms of the following: visualization of the target lesions, SpyGlass-guided adequate tissue sampling and complete stone removal. Results 108 consecutive patients underwent SGDVS procedures. 76 patients (70.4%) were referred for indeterminate biliary strictures, 32 patients (29.6%) for stone removal. The total success rate of both diagnosis and treatment is 89.8% (97/108), 68 cases successfully completed diagnosis by SGDVS and the diagnostic success rate was 89.5% (68/76). Complete removal of stones were completed in 29 cases and the treatment success rate was 90.6% (29/32). The incidence of complications was 10.2% (11/108). Conclusion SGVDS can improve the accuracy of diagnosis of indeterminate biliary lesions through direct vision observation and adequate sampling. In addition, SGVDS combined with stone removal and lithotripsy equipment for complex bile duct stones, it can be safely performed with a high success rate.