Novel application of SpyGlass™ cholangioscopy in the diagnosis and treatment of extrahepatic biliary obstruction in infants

Kathryn J. Rowland, Aaron J. Cunningham, Saad F. Jazrawi, Ronald Prauner, Marilyn Butler, Mubeen Jafri

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish (US)
Pages (from-to)19-22
Number of pages4
JournalJournal of Pediatric Surgery Case Reports
Volume38
DOIs
StatePublished - Nov 1 2018

Fingerprint

Bile Ducts
Endoscopic Retrograde Cholangiopancreatography
Common Bile Duct
Embryonal Rhabdomyosarcoma
Biopsy
Common Hepatic Duct
Fluoroscopy
Therapeutics
Jaundice
Radiography
Catheterization
Stents
Radiotherapy
Pathology
Drug Therapy

Keywords

  • Cholangioscopy
  • Pediatric
  • SpyGlass™

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Surgery

Cite this

Novel application of SpyGlass™ cholangioscopy in the diagnosis and treatment of extrahepatic biliary obstruction in infants. / Rowland, Kathryn J.; Cunningham, Aaron J.; Jazrawi, Saad F.; Prauner, Ronald; Butler, Marilyn; Jafri, Mubeen.

In: Journal of Pediatric Surgery Case Reports, Vol. 38, 01.11.2018, p. 19-22.

Research output: Contribution to journalArticle

@article{bafdb139f5424e1ba5e929f5816b9f45,
title = "Novel application of SpyGlass™ cholangioscopy in the diagnosis and treatment of extrahepatic biliary obstruction in infants",
abstract = "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, Pediatric, SpyGlass™",
author = "Rowland, {Kathryn J.} and Cunningham, {Aaron J.} and Jazrawi, {Saad F.} and Ronald Prauner and Marilyn Butler and Mubeen Jafri",
year = "2018",
month = "11",
day = "1",
doi = "10.1016/j.epsc.2018.07.028",
language = "English (US)",
volume = "38",
pages = "19--22",
journal = "Journal of Pediatric Surgery Case Reports",
issn = "2213-5766",
publisher = "Elsevier BV",

}

TY - JOUR

T1 - Novel application of SpyGlass™ cholangioscopy in the diagnosis and treatment of extrahepatic biliary obstruction in infants

AU - Rowland, Kathryn J.

AU - Cunningham, Aaron J.

AU - Jazrawi, Saad F.

AU - Prauner, Ronald

AU - Butler, Marilyn

AU - Jafri, Mubeen

PY - 2018/11/1

Y1 - 2018/11/1

N2 - 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.

AB - 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.

KW - Cholangioscopy

KW - Pediatric

KW - SpyGlass™

UR - http://www.scopus.com/inward/record.url?scp=85051122722&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85051122722&partnerID=8YFLogxK

U2 - 10.1016/j.epsc.2018.07.028

DO - 10.1016/j.epsc.2018.07.028

M3 - Article

AN - SCOPUS:85051122722

VL - 38

SP - 19

EP - 22

JO - Journal of Pediatric Surgery Case Reports

JF - Journal of Pediatric Surgery Case Reports

SN - 2213-5766

ER -