The diagnosis of biliary strictures remains challenging, and it can be difficult to differentiate between benign and malignant strictures. Cholangiography characteristics alone obtained during ERCP or MRCP may not be specific enough to indicate unambiguous decisions on patient management.
Peroral choledochoscopy can improve the diagnosis of indeterminate strictures by visualisation of the mucosa at the stricture site and enables obtaining directed biopsies in order to increase the diagnostic yield. Cholangioscopy options have been limited so far.
Some workplaces, including our department in Trnava, worked with the first generation cholangioscopy (SpyGlass(R)), which was based on the fibre-optic principle and image quality was not perfect. Therapeutic interventions and taking biopsy specimens was also difficult with the first generation SpyGlass(R).
The new system working on principle of a digital imaging (SpyglassTM DS) is characterized by improved image quality, which is incomparably better compared to the first generation, taking biopsies seems to be easier as well. The image quality is higher compared to the first generation and taking biopsies also seems to be easier.
In this article we summarise our first experience with the new SpyGlassTM DS.