The role of SpyGlass Direct Visualization System on Patient with Indeterminate biliary strictures: A case report

Acta Medica Indonesiana

Manu Tandan¹  Dadang Makmun²  Muhammad Miftahussurur³ 

[1] Asian Institute of Gastroenterology, Hyderabad, India;Division of Gastroenterology, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo Hospital, Jakarta, Indonesia;Institute of Tropical Disease, Universitas Airlangga, Surabaya, Indonesia.Gastroentero-Hepatology division, Department of Internal Medicine, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia.Department of Environmental and Preventive Medicine, Oita University Faculty of Medicine, Yufu 8795593, Japan;

关键词: biliary stricture;    cancer;    spyglass ds;    cholangiocarcinoma;   

DOI  :  

来源: DOAJ

【 摘 要 】

Biliary strictures diagnosis has become a challenge where benign conditions could mimic a malignant process. Recently, SpyGlass DS overcame the limitations by allowing direct visualization of the biliary tree. A 65 years old Indian patient complaints of jaundice with total and direct bilirubin of 23.3 mg/dL and 16.2 mg/dL, respectively. Liver function test, gamma-glutamyltransferase and CA 19-9 were increased. Transabdominal ultrasound and abdominal CT supported dilatation of common bile duct (CBD) with abrupt narrowing showing periductal enhancement at supra pancreatic level and stricture. Endoscopic ultrasound showed intrahepatic CBD stricture with dilated proximal CBD and sludge ball. Endoscopic retrograde cholangiopancreatography showed mid CBD stricture. Although brush cytology results suggested low grade dysplasia and no definite evidence of malignancy, cholangioscopy using SpyGlass DS found nodularity with abnormal vascularity seen in mid of CBD suggesting malignancy, confirmed with histopathology as cholangiocarcinoma. We reported additional value of SpyGlass DS for detecting cholangiocarcinoma in an indeterminate biliary stricture patient.

【 授权许可】

Unknown