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Mistakes in cholangioscopy and how to avoid them

Marianna Arvanitakis, Malina Wiesand, Paraskevas Gkolfakis

Summary

AI Generated

Cholangioscopy is a minimally invasive endoscopic technique enabling direct visualisation of bile ducts for both diagnostic and therapeutic purposes in biliary disease management.

  • Cholangioscopy allows characterisation and tissue acquisition for strictures of undetermined aetiology.
  • The technique facilitates extension assessment for biliary cancer.
  • Cholangioscopy provides intraductal lithotripsy for complex biliary stones.
  • The technique is useful in managing biliary diseases through both diagnostic and therapeutic interventions.
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Was this helpful?

Thanks for your feedback.

This summary was generated by an AI large language model based on the content transcript. It is for informational purposes only and should not be considered a substitute for clinical judgment. Always rely on your professional expertise and the full clinical context when making clinical decisions.

References

Mistakes
References
Mistake 1 Mistake 2 Mistake 3 Mistake 4 Mistake 5 Mistake 6 Mistake 7 Mistake 8 Mistake 9
1.
Troncone E, Mossa M, De Vico P, et al. Difficult Biliary Stones: A Comprehensive Review of New and Old Lithotripsy Techniques. Medicina (Kaunas) 2022; 58. [Link]
2.
Cotton PB and Leung JWC. ERCP : the fundamentals. Third edition. ed. Hoboken, NJ, USA: Wiley-Blackwell, 2020, p.xv, 410 pages : illustrations (some color). [Link]
3.
Karagyozov P, Boeva I and Tishkov I. Role of digital single-operator cholangioscopy in the diagnosis and treatment of biliary disorders. World J Gastrointest Endosc 2019; 11: 31-40. [Link]
4.
Mauro A, Mazza S, Scalvini D, et al. The Role of Cholangioscopy in Biliary Diseases. Diagnostics (Basel) 2023; 13. [Link]
5.
Subhash A, Abadir A, Iskander JM, et al. Applications, Limitations, and Expansion of Cholangioscopy in Clinical Practice. Gastroenterol Hepatol (N Y) 2021; 17: 110-120. [Link]
6.
Subhash A, Buxbaum JL and Tabibian JH. Peroral cholangioscopy: Update on the state-of-the-art. World J Gastrointest Endosc 2022; 14: 63-76. [Link]
7.
Moon JH, Terheggen G, Choi HJ, et al. Peroral Cholangioscopy: Diagnostic and Therapeutic Applications. Gastroenterology 2013; 144: 276-282. [Link]
8.
Itoi T, Reddy DN, Sofuni A, et al. Clinical evaluation of a prototype multi-bending peroral direct cholangioscope. Digestive Endoscopy 2014; 26: 100-107. [Link]
9.
Nabi Z and Reddy DN. Multidisciplinary Approach to Indeterminate Biliary Strictures. Gastrointest Endosc Clin N Am 2022; 32: 411-425. [Link]
10.
Shima Y, Sugiyama H, Ogasawara S, et al. Diagnostic value of peroral cholangioscopy in addition to computed tomography for indeterminate biliary strictures. Surg Endosc 2022; 36: 3408-3417. [Link]
11.
Rösch T, Meining A, Frühmorgen S, et al. A prospective comparison of the diagnostic accuracy of ERCP, MRCP, CT, and EUS in biliary strictures. Gastrointest Endosc 2002; 55: 870-876. [Link]
12.
Romagnuolo J, Bardou M, Rahme E, et al. Magnetic resonance cholangiopancreatography: a meta-analysis of test performance in suspected biliary disease. Ann Intern Med 2003; 139: 547-557. [Link]
13.
Saluja SS, Sharma R, Pal S, et al. Differentiation between benign and malignant hilar obstructions using laboratory and radiological investigations: a prospective study. HPB (Oxford) 2007; 9: 373-382. [Link]
14.
Elmunzer BJ, Maranki JL, Gómez V, et al. ACG Clinical Guideline: Diagnosis and Management of Biliary Strictures. Am J Gastroenterol 2023; 118: 405-426. [Link]
15.
Lee YN, Moon JH, Choi HJ, et al. Tissue acquisition for diagnosis of biliary strictures using peroral cholangioscopy or endoscopic ultrasound-guided fine-needle aspiration. Endoscopy 2019; 51: 50-59. [Link]
16.
Tyberg A, Raijman I, Siddiqui A, et al. Digital Pancreaticocholangioscopy for Mapping of Pancreaticobiliary Neoplasia: Can We Alter the Surgical Resection Margin? J Clin Gastroenterol 2019; 53: 71-75. [Link]
17.
Phillpotts S, Webster G and Arvanitakis M. Endoscopic Management of Complex Biliary Stones. Gastrointest Endosc Clin N Am 2022; 32: 477-492. [Link]
18.
Angsuwatcharakon P, Kulpatcharapong S, Moon JH, et al. Consensus guidelines on the role of cholangioscopy to diagnose indeterminate biliary stricture. HPB (Oxford) 2022; 24: 17-29. [Link]
19.
Othman MO, Guerrero R, Elhanafi S, et al. A prospective study of the risk of bacteremia in directed cholangioscopic examination of the common bile duct. Gastrointest Endosc 2016; 83: 151-157. [Link]
20.
Thosani N, Zubarik RS, Kochar R, et al. Prospective evaluation of bacteremia rates and infectious complications among patients undergoing single-operator choledochoscopy during ERCP. Endoscopy 2016; 48: 424-431. [Link]
21.
Turowski F, Hügle U, Dormann A, et al. Diagnostic and therapeutic single-operator cholangiopancreatoscopy with SpyGlassDS™: results of a multicenter retrospective cohort study. Surg Endosc 2018; 32: 3981-3988. [Link]
22.
Sethi A, Chen YK, Austin GL, et al. ERCP with cholangiopancreatoscopy may be associated with higher rates of complications than ERCP alone: a single-center experience. Gastrointest Endosc 2011; 73: 251-256. [Link]
23.
Gustafsson A, Enochsson L, Tingstedt B, et al. Antibiotic prophylaxis and post-procedure infectious complications in endoscopic retrograde cholangiopancreatography with peroral cholangioscopy. Endosc Int Open 2023; 11: E1177-e1183. [Link]
24.
Chon HK, Choi KH, Seo SH, et al. Efficacy and Safety of Percutaneous Transhepatic Cholangioscopy with the Spyglass DS Direct Visualization System in Patients with Surgically Altered Anatomy: A Pilot Study. Gut Liver 2022; 16: 111-117. [Link]
25.
Khara HS, Parvataneni S, Park S, et al. Review of ERCP Techniques in Roux-en-Y Gastric Bypass Patients: Highlight on the Novel EUS-Directed Transgastric ERCP (EGDE) Technique. Curr Gastroenterol Rep 2021; 23: 10. [Link]
26.
Tarantino I and Rizzo GEM. Biliopancreatic Endoscopy in Altered Anatomy. Medicina (Kaunas) 2021; 57. [Link]
27.
Bang JY, Navaneethan U, Hasan M, et al. Optimizing Outcomes of Single-Operator Cholangioscopy-Guided Biopsies Based on a Randomized Trial. Clin Gastroenterol Hepatol 2020; 18: 441-448.e441. [Link]
28.
Komanduri S, Thosani N, Abu Dayyeh BK, et al. Cholangiopancreatoscopy. Gastrointest Endosc 2016; 84: 209-221. [Link]
29.
Moon JH and Choi HJ. The role of direct peroral cholangioscopy using an ultraslim endoscope for biliary lesions: indications, limitations, and complications. Clin Endosc 2013; 46: 537-539. [Link]
30.
Becq A, Soualy A and Camus M. Cholangioscopy for biliary diseases. Curr Opin Gastroenterol 2023; 39: 67-74. [Link]
31.
Parsi MA. Direct peroral cholangioscopy. World J Gastrointest Endosc 2014; 6: 1-5. [Link]
32.
Parsi MA, Stevens T and Vargo JJ. Diagnostic and therapeutic direct peroral cholangioscopy using an intraductal anchoring balloon. World J Gastroenterol 2012; 18: 3992-3996. [Link]
33.
Shin IS, Moon JH, Lee YN, et al. Comparison of disposable digital single-operator cholangioscopy versus direct peroral cholangioscopy for the diagnosis of intraductal superficial lesions of the bile duct. Endoscopy 2024. [Link]
34.
Tejido C, Puga M, Regueiro C, et al. Evaluation of the effectiveness and safety of single-operator cholangiopancreatoscopy with the SpyGlass™ system. Gastroenterol Hepatol 2024; 47: 170-178. [Link]
35.
Chen YK, Parsi MA, Binmoeller KF, et al. Single-operator cholangioscopy in patients requiring evaluation of bile duct disease or therapy of biliary stones (with videos). Gastrointest Endosc 2011; 74: 805-814. [Link]
36.
Laleman W, Verraes K, Van Steenbergen W, et al. Usefulness of the single-operator cholangioscopy system SpyGlass in biliary disease: a single-center prospective cohort study and aggregated review. Surg Endosc 2017; 31: 2223-2232. [Link]
37.
Lin CC, Chen CJ, Chu CH, et al. Evaluating the feasibility of direct peroral cholangioscopy training with an endoscopic simulator. Dig Dis Sci 2012; 57: 2016-2021. [Link]
38.
Alameel T, Bain V and Sandha G. Clinical application of a single-operator direct visualization system improves the diagnostic and therapeutic yield of endoscopic retrograde cholangiopancreatography. Can J Gastroenterol 2013; 27: 15-19. [Link]
39.
Arvanitakis M. Digital single-operator cholangioscopy-guided biopsy for indeterminate biliary strictures: Seeing is believing? Gastrointest Endosc 2020; 91: 1114-1116. [Link]
40.
Pouw RE, Barret M, Biermann K, et al. Endoscopic tissue sampling - Part 1: Upper gastrointestinal and hepatopancreatobiliary tracts. European Society of Gastrointestinal Endoscopy (ESGE) Guideline. Endoscopy 2021; 53: 1174-1188. [Link]
41.
Seo DW, Lee SK, Yoo KS, et al. Cholangioscopic findings in bile duct tumors. Gastrointest Endosc 2000; 52: 630-634. [Link]
42.
Wen LJ, Chen JH, Xu HJ, et al. Efficacy and Safety of Digital Single-Operator Cholangioscopy in the Diagnosis of Indeterminate Biliary Strictures by Targeted Biopsies: A Systematic Review and Meta-Analysis. Diagnostics (Basel) 2020; 10. [Link]
43.
Fujii-Lau LL, Thosani NC, Al-Haddad M, et al. American Society for Gastrointestinal Endoscopy guideline on the role of endoscopy in the diagnosis of malignancy in biliary strictures of undetermined etiology: summary and recommendations. Gastrointest Endosc 2023; 98: 685-693. [Link]
44.
Gerges C, Beyna T, Tang RSY, et al. Digital single-operator peroral cholangioscopy-guided biopsy sampling versus ERCP-guided brushing for indeterminate biliary strictures: a prospective, randomized, multicenter trial (with video). Gastrointest Endosc 2020; 91: 1105-1113. [Link]
45.
Sethi A, Doukides T, Sejpal DV, et al. Interobserver agreement for single operator choledochoscopy imaging: can we do better? Diagn Ther Endosc 2014; 2014: 730731. [Link]
46.
Jang S, Stevens T, Kou L, et al. Efficacy of digital single-operator cholangioscopy and factors affecting its accuracy in the evaluation of indeterminate biliary stricture. Gastrointest Endosc 2020; 91: 385-393.e381. [Link]
47.
Almadi MA, Itoi T, Moon JH, et al. Using single-operator cholangioscopy for endoscopic evaluation of indeterminate biliary strictures: results from a large multinational registry. Endoscopy 2020; 52: 574-582. [Link]
48.
Gerhards MF, Vos P, van Gulik TM, et al. Incidence of benign lesions in patients resected for suspicious hilar obstruction. Br J Surg 2001; 88: 48-51. [Link]
49.
Matsumori T, Uza N, Okada H, et al. Innovative method for the diagnosis of bile duct lesions using a novel tapered-tip sheath system to facilitate biliary biopsies. Gastrointest Endosc 2023; 98: 43-50.e41. [Link]
50.
Manti M, Shah J, Papaefthymiou A, et al. Endoscopic Management of Difficult Biliary Stones: An Evergreen Issue. Medicina (Kaunas) 2024; 60. [Link]
51.
Seitz U, Bapaye A, Bohnacker S, et al. Advances in therapeutic endoscopic treatment of common bile duct stones. World J Surg 1998; 22: 1133-1144. [Link]
52.
Manes G, Paspatis G, Aabakken L, et al. Endoscopic management of common bile duct stones: European Society of Gastrointestinal Endoscopy (ESGE) guideline. Endoscopy 2019; 51: 472-491. [Link]
53.
Watson RR, Parsi MA, Aslanian HR, et al. Biliary and pancreatic lithotripsy devices. VideoGIE 2018; 3: 329-338. [Link]
54.
Lee TH, Moon JH, Lee YN, et al. A Preliminary Study on the Efficacy of Single-Operator Cholangioscopy with a New Basket for Residual Stone Retrieval After Mechanical Lithotripsy. Dig Dis Sci 2022; 67: 2571-2576. [Link]
55.
Fugazza A, Gabbiadini R, Tringali A, et al. Digital single-operator cholangioscopy in diagnostic and therapeutic bilio-pancreatic diseases: A prospective, multicenter study. Dig Liver Dis 2022; 54: 1243-1249. [Link]
56.
McCarty TR, Gulati R and Rustagi T. Efficacy and safety of peroral cholangioscopy with intraductal lithotripsy for difficult biliary stones: a systematic review and meta-analysis. Endoscopy 2021; 53: 110-122. [Link]

Abstract

Cholangioscopy is a minimally invasive, endoscopic technique that allows direct visualisation of the bile ducts, facilitating both diagnostic and therapeutic interventions. It is a useful tool in managing biliary diseases, allowing characterisation and tissue acquisition for strictures of undetermined aetiology, facilitating extension assessment for biliary cancer and providing intraductal lithotripsy for complex biliary stones.

Published

2025

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UEG Mistakes In Articles
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Mistakes in transjugular intrahepatic portosystemic shunt (TIPS) in cirrhosis and how to avoid them

Kymentie Ferdinande, Alberto Zanetto, Virginia Hernández-Gea, Marco Senzolo

Summary

AI Generated

Summary is not available for this content yet.

Download PDF

Was this helpful?

Thanks for your feedback.

This summary was generated by an AI large language model based on the content transcript. It is for informational purposes only and should not be considered a substitute for clinical judgment. Always rely on your professional expertise and the full clinical context when making clinical decisions.

References

Mistakes
References
Mistake 1 Mistake 2 Mistake 3 Mistake 4 Mistake 5 Mistake 6 Mistake 7 Mistake 8 Mistake 9
1.
Troncone E, Mossa M, De Vico P, et al. Difficult Biliary Stones: A Comprehensive Review of New and Old Lithotripsy Techniques. Medicina (Kaunas) 2022; 58. [Link]
2.
Cotton PB and Leung JWC. ERCP : the fundamentals. Third edition. ed. Hoboken, NJ, USA: Wiley-Blackwell, 2020, p.xv, 410 pages : illustrations (some color). [Link]
3.
Karagyozov P, Boeva I and Tishkov I. Role of digital single-operator cholangioscopy in the diagnosis and treatment of biliary disorders. World J Gastrointest Endosc 2019; 11: 31-40. [Link]
4.
Mauro A, Mazza S, Scalvini D, et al. The Role of Cholangioscopy in Biliary Diseases. Diagnostics (Basel) 2023; 13. [Link]
5.
Subhash A, Abadir A, Iskander JM, et al. Applications, Limitations, and Expansion of Cholangioscopy in Clinical Practice. Gastroenterol Hepatol (N Y) 2021; 17: 110-120. [Link]
6.
Subhash A, Buxbaum JL and Tabibian JH. Peroral cholangioscopy: Update on the state-of-the-art. World J Gastrointest Endosc 2022; 14: 63-76. [Link]
7.
Moon JH, Terheggen G, Choi HJ, et al. Peroral Cholangioscopy: Diagnostic and Therapeutic Applications. Gastroenterology 2013; 144: 276-282. [Link]
8.
Itoi T, Reddy DN, Sofuni A, et al. Clinical evaluation of a prototype multi-bending peroral direct cholangioscope. Digestive Endoscopy 2014; 26: 100-107. [Link]
9.
Nabi Z and Reddy DN. Multidisciplinary Approach to Indeterminate Biliary Strictures. Gastrointest Endosc Clin N Am 2022; 32: 411-425. [Link]
10.
Shima Y, Sugiyama H, Ogasawara S, et al. Diagnostic value of peroral cholangioscopy in addition to computed tomography for indeterminate biliary strictures. Surg Endosc 2022; 36: 3408-3417. [Link]
11.
Rösch T, Meining A, Frühmorgen S, et al. A prospective comparison of the diagnostic accuracy of ERCP, MRCP, CT, and EUS in biliary strictures. Gastrointest Endosc 2002; 55: 870-876. [Link]
12.
Romagnuolo J, Bardou M, Rahme E, et al. Magnetic resonance cholangiopancreatography: a meta-analysis of test performance in suspected biliary disease. Ann Intern Med 2003; 139: 547-557. [Link]
13.
Saluja SS, Sharma R, Pal S, et al. Differentiation between benign and malignant hilar obstructions using laboratory and radiological investigations: a prospective study. HPB (Oxford) 2007; 9: 373-382. [Link]
14.
Elmunzer BJ, Maranki JL, Gómez V, et al. ACG Clinical Guideline: Diagnosis and Management of Biliary Strictures. Am J Gastroenterol 2023; 118: 405-426. [Link]
15.
Lee YN, Moon JH, Choi HJ, et al. Tissue acquisition for diagnosis of biliary strictures using peroral cholangioscopy or endoscopic ultrasound-guided fine-needle aspiration. Endoscopy 2019; 51: 50-59. [Link]
16.
Tyberg A, Raijman I, Siddiqui A, et al. Digital Pancreaticocholangioscopy for Mapping of Pancreaticobiliary Neoplasia: Can We Alter the Surgical Resection Margin? J Clin Gastroenterol 2019; 53: 71-75. [Link]
17.
Phillpotts S, Webster G and Arvanitakis M. Endoscopic Management of Complex Biliary Stones. Gastrointest Endosc Clin N Am 2022; 32: 477-492. [Link]
18.
Angsuwatcharakon P, Kulpatcharapong S, Moon JH, et al. Consensus guidelines on the role of cholangioscopy to diagnose indeterminate biliary stricture. HPB (Oxford) 2022; 24: 17-29. [Link]
19.
Othman MO, Guerrero R, Elhanafi S, et al. A prospective study of the risk of bacteremia in directed cholangioscopic examination of the common bile duct. Gastrointest Endosc 2016; 83: 151-157. [Link]
20.
Thosani N, Zubarik RS, Kochar R, et al. Prospective evaluation of bacteremia rates and infectious complications among patients undergoing single-operator choledochoscopy during ERCP. Endoscopy 2016; 48: 424-431. [Link]
21.
Turowski F, Hügle U, Dormann A, et al. Diagnostic and therapeutic single-operator cholangiopancreatoscopy with SpyGlassDS™: results of a multicenter retrospective cohort study. Surg Endosc 2018; 32: 3981-3988. [Link]
22.
Sethi A, Chen YK, Austin GL, et al. ERCP with cholangiopancreatoscopy may be associated with higher rates of complications than ERCP alone: a single-center experience. Gastrointest Endosc 2011; 73: 251-256. [Link]
23.
Gustafsson A, Enochsson L, Tingstedt B, et al. Antibiotic prophylaxis and post-procedure infectious complications in endoscopic retrograde cholangiopancreatography with peroral cholangioscopy. Endosc Int Open 2023; 11: E1177-e1183. [Link]
24.
Chon HK, Choi KH, Seo SH, et al. Efficacy and Safety of Percutaneous Transhepatic Cholangioscopy with the Spyglass DS Direct Visualization System in Patients with Surgically Altered Anatomy: A Pilot Study. Gut Liver 2022; 16: 111-117. [Link]
25.
Khara HS, Parvataneni S, Park S, et al. Review of ERCP Techniques in Roux-en-Y Gastric Bypass Patients: Highlight on the Novel EUS-Directed Transgastric ERCP (EGDE) Technique. Curr Gastroenterol Rep 2021; 23: 10. [Link]
26.
Tarantino I and Rizzo GEM. Biliopancreatic Endoscopy in Altered Anatomy. Medicina (Kaunas) 2021; 57. [Link]
27.
Bang JY, Navaneethan U, Hasan M, et al. Optimizing Outcomes of Single-Operator Cholangioscopy-Guided Biopsies Based on a Randomized Trial. Clin Gastroenterol Hepatol 2020; 18: 441-448.e441. [Link]
28.
Komanduri S, Thosani N, Abu Dayyeh BK, et al. Cholangiopancreatoscopy. Gastrointest Endosc 2016; 84: 209-221. [Link]
29.
Moon JH and Choi HJ. The role of direct peroral cholangioscopy using an ultraslim endoscope for biliary lesions: indications, limitations, and complications. Clin Endosc 2013; 46: 537-539. [Link]
30.
Becq A, Soualy A and Camus M. Cholangioscopy for biliary diseases. Curr Opin Gastroenterol 2023; 39: 67-74. [Link]
31.
Parsi MA. Direct peroral cholangioscopy. World J Gastrointest Endosc 2014; 6: 1-5. [Link]
32.
Parsi MA, Stevens T and Vargo JJ. Diagnostic and therapeutic direct peroral cholangioscopy using an intraductal anchoring balloon. World J Gastroenterol 2012; 18: 3992-3996. [Link]
33.
Shin IS, Moon JH, Lee YN, et al. Comparison of disposable digital single-operator cholangioscopy versus direct peroral cholangioscopy for the diagnosis of intraductal superficial lesions of the bile duct. Endoscopy 2024. [Link]
34.
Tejido C, Puga M, Regueiro C, et al. Evaluation of the effectiveness and safety of single-operator cholangiopancreatoscopy with the SpyGlass™ system. Gastroenterol Hepatol 2024; 47: 170-178. [Link]
35.
Chen YK, Parsi MA, Binmoeller KF, et al. Single-operator cholangioscopy in patients requiring evaluation of bile duct disease or therapy of biliary stones (with videos). Gastrointest Endosc 2011; 74: 805-814. [Link]
36.
Laleman W, Verraes K, Van Steenbergen W, et al. Usefulness of the single-operator cholangioscopy system SpyGlass in biliary disease: a single-center prospective cohort study and aggregated review. Surg Endosc 2017; 31: 2223-2232. [Link]
37.
Lin CC, Chen CJ, Chu CH, et al. Evaluating the feasibility of direct peroral cholangioscopy training with an endoscopic simulator. Dig Dis Sci 2012; 57: 2016-2021. [Link]
38.
Alameel T, Bain V and Sandha G. Clinical application of a single-operator direct visualization system improves the diagnostic and therapeutic yield of endoscopic retrograde cholangiopancreatography. Can J Gastroenterol 2013; 27: 15-19. [Link]
39.
Arvanitakis M. Digital single-operator cholangioscopy-guided biopsy for indeterminate biliary strictures: Seeing is believing? Gastrointest Endosc 2020; 91: 1114-1116. [Link]
40.
Pouw RE, Barret M, Biermann K, et al. Endoscopic tissue sampling - Part 1: Upper gastrointestinal and hepatopancreatobiliary tracts. European Society of Gastrointestinal Endoscopy (ESGE) Guideline. Endoscopy 2021; 53: 1174-1188. [Link]
41.
Seo DW, Lee SK, Yoo KS, et al. Cholangioscopic findings in bile duct tumors. Gastrointest Endosc 2000; 52: 630-634. [Link]
42.
Wen LJ, Chen JH, Xu HJ, et al. Efficacy and Safety of Digital Single-Operator Cholangioscopy in the Diagnosis of Indeterminate Biliary Strictures by Targeted Biopsies: A Systematic Review and Meta-Analysis. Diagnostics (Basel) 2020; 10. [Link]
43.
Fujii-Lau LL, Thosani NC, Al-Haddad M, et al. American Society for Gastrointestinal Endoscopy guideline on the role of endoscopy in the diagnosis of malignancy in biliary strictures of undetermined etiology: summary and recommendations. Gastrointest Endosc 2023; 98: 685-693. [Link]
44.
Gerges C, Beyna T, Tang RSY, et al. Digital single-operator peroral cholangioscopy-guided biopsy sampling versus ERCP-guided brushing for indeterminate biliary strictures: a prospective, randomized, multicenter trial (with video). Gastrointest Endosc 2020; 91: 1105-1113. [Link]
45.
Sethi A, Doukides T, Sejpal DV, et al. Interobserver agreement for single operator choledochoscopy imaging: can we do better? Diagn Ther Endosc 2014; 2014: 730731. [Link]
46.
Jang S, Stevens T, Kou L, et al. Efficacy of digital single-operator cholangioscopy and factors affecting its accuracy in the evaluation of indeterminate biliary stricture. Gastrointest Endosc 2020; 91: 385-393.e381. [Link]
47.
Almadi MA, Itoi T, Moon JH, et al. Using single-operator cholangioscopy for endoscopic evaluation of indeterminate biliary strictures: results from a large multinational registry. Endoscopy 2020; 52: 574-582. [Link]
48.
Gerhards MF, Vos P, van Gulik TM, et al. Incidence of benign lesions in patients resected for suspicious hilar obstruction. Br J Surg 2001; 88: 48-51. [Link]
49.
Matsumori T, Uza N, Okada H, et al. Innovative method for the diagnosis of bile duct lesions using a novel tapered-tip sheath system to facilitate biliary biopsies. Gastrointest Endosc 2023; 98: 43-50.e41. [Link]
50.
Manti M, Shah J, Papaefthymiou A, et al. Endoscopic Management of Difficult Biliary Stones: An Evergreen Issue. Medicina (Kaunas) 2024; 60. [Link]
51.
Seitz U, Bapaye A, Bohnacker S, et al. Advances in therapeutic endoscopic treatment of common bile duct stones. World J Surg 1998; 22: 1133-1144. [Link]
52.
Manes G, Paspatis G, Aabakken L, et al. Endoscopic management of common bile duct stones: European Society of Gastrointestinal Endoscopy (ESGE) guideline. Endoscopy 2019; 51: 472-491. [Link]
53.
Watson RR, Parsi MA, Aslanian HR, et al. Biliary and pancreatic lithotripsy devices. VideoGIE 2018; 3: 329-338. [Link]
54.
Lee TH, Moon JH, Lee YN, et al. A Preliminary Study on the Efficacy of Single-Operator Cholangioscopy with a New Basket for Residual Stone Retrieval After Mechanical Lithotripsy. Dig Dis Sci 2022; 67: 2571-2576. [Link]
55.
Fugazza A, Gabbiadini R, Tringali A, et al. Digital single-operator cholangioscopy in diagnostic and therapeutic bilio-pancreatic diseases: A prospective, multicenter study. Dig Liver Dis 2022; 54: 1243-1249. [Link]
56.
McCarty TR, Gulati R and Rustagi T. Efficacy and safety of peroral cholangioscopy with intraductal lithotripsy for difficult biliary stones: a systematic review and meta-analysis. Endoscopy 2021; 53: 110-122. [Link]

Abstract

TIPS success is rarely about the procedure alone. It depends on decisions made across the entire clinical pathway.

New in the UEG "Mistakes in…" series: Ferdinande et al., present 10 common mistakes in TIPS for cirrhosis, from referral to long-term follow-up.

Key themes:
• Screen the heart first: cardiac decompensation follows TIPS in up to 20% of patients.
• Refer early: delay costs survival in refractory ascites and high-risk variceal bleeding.
• Prevent encephalopathy by design: careful selection, nutrition, rifaximin, and controlled underdilation.
• Individualise haemodynamic targets and follow up structurally.

Topics

Hepatobiliary Surgery

Published

2026

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Abstract

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Abstract

Topics

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Abstract

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2024

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Abstract

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2025

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This summary was generated by an AI large language model based on the content transcript. It is for informational purposes only and should not be considered a substitute for clinical judgment. Always rely on your professional expertise and the full clinical context when making clinical decisions.

Abstract

Topics

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Published

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