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Klinischer Stellenwert der modularen Cholangioskopie

Clinical importance of modular cholangioscopy

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Zusammenfassung

In den letzten 10 Jahren hat sich die Cholangioskopie durch technische Fortschritte stark weiterentwickelt. Derzeit stehen modulare Cholangioskopiesysteme, die ein breites Spektrum diagnostischer und therapeutischer Endoskopien im Gallengangsystem und vereinzelt auch bereits im Pankreasgang ermöglichen, zur Verfügung. Die Hauptindikationen für eine Cholangioskopie sind die Abklärung dignitätsunklarer Gallengangstenosen mit der Möglichkeit der cholangioskopiegestützten Biopsie und die komplizierte Choledocholithiasis. Im vorliegenden Artikel wird der klinische Stellenwert der modularen Cholangioskopie am Beispiel des SpyGlass™DS dargestellt und eine zusammenfassende Übersicht über die bislang verfügbaren wissenschaftlichen Daten gegeben. Durch eine vereinfachte Handhabung der Hardware und die sehr gute Kombination mit weiterem endoskopischem Zubehör (Biopsiezangen, Lithotripsiesonden) ist die modulare Cholangioskopie „salonfähig“ geworden. Einer breiten Anwendung dieser Technologie in Zentren mit hoher Expertise für die endoskopische retrograde Cholangiopankreatikographie steht nichts mehr im Wege.

Abstract

During the last 10 years the technology behind cholangioscopy has been substantially improved. Currently available modular cholangioscopic systems offer the possibility for a wide spectrum of diagnostic and therapeutic procedures in the hepatobiliary system and recently also in the pancreatic duct. The main indications for cholangioscopy are the differential diagnosis of bile duct stenosis of uncertain behaviour with the option to acquire targeted biopsies as well as interventions in difficult choledocholithiasis. In the present article, the clinical value of SpyGlass™DS is presented together with an overview of the available scientific evidence. Due to a more ergonomic setup and the opportunity to use further endoscopic accessories (biopsy forceps, lithotripsy probes), modular cholangioscopy has become a powerful tool. A more widespread use of this technology in endoscopic centers with high ERCP expertise is now possible.

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Authors and Affiliations

  1. Medizinische Klinik mit Schwerpunkt Gastroenterologie, Infektiologie, Rheumatologie, Charité Universitätsmedizin Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, 12203, Berlin, Deutschland

    C. Bojarski & F. Turowski

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  1. C. Bojarski
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  2. F. Turowski
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Correspondence to C. Bojarski.

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Interessenkonflikt

C. Bojarski ist beratend für den ABW-Verlag in Berlin tätig. Er hat im Jahr 2016 einmal Reisekosten von der Boston Scientific Corporation im Rahmen eines Axios™-Trainings erhalten und ist als Referent für die AbbVie Deutschland GmbH & Co. KG, die Fortbildungsakademie der Charité, Dr. Falk Pharma GmbH, Fresenius SE & Co. KGaA, Medtronic GmbH sowie das Philipp-Pfaff-Institut in Berlin tätig. Alle Referentenhonorare wurden zu 100 % an Ärzte ohne Grenzen e. V. gespendet. F. Turowski gibt an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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A. Dormann, Köln

R. Jakobs, Ludwigshafen

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Bojarski, C., Turowski, F. Klinischer Stellenwert der modularen Cholangioskopie. Gastroenterologe 12, 202–207 (2017). https://doi.org/10.1007/s11377-017-0161-5

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  • DOI: https://doi.org/10.1007/s11377-017-0161-5

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