Cholangioscopy (Spyglass)

May 3, 2022

What Is A Cholangioscopy?

Spyglass cholangioscopy is a non-invasive endoscopic procedure that can be used for visualization, diagnostic evaluation, and therapeutic intervention of bile duct abnormalities. In the past, cholangioscopes were very fragile, had limited maneuverability, and required two operators. By overcoming these limitations, the spyglass system is considered a breakthrough in the field of endoscopic technology.cholangioscopy-(spyglass)

It can be used in the evaluation and management of diseases such as:

  • Biliary system cancer
  • Bile duct cancer
  • Gallbladder cancer
  • Gallstones
  • Primary sclerosing cholangitis
  • Biliary papillomatosis

The spyglass system can be used by a single operator and has increased maneuverability allowing easy visualization of the biliary tree, extraction of tissue for biopsy, and treatment of bile stones, strictures, or other pathology. It has separate channels for the use of instruments and irrigation. The procedure requires decreased fluoroscopy time which results in decreased radiation exposure.

You will generally have to lie in the prone position for the procedure. The spyglass access and delivery catheter will be attached to a duodenoscope which will be inserted through your mouth down into the stomach until it reaches the duodenum where the opening of the pancreatic and biliary ducts are visualized. The spyglass catheter will then be advanced into the common bile duct under fluoroscopic guidance to visualize the biliary tree and perform the diagnostic or therapeutic procedure as required.

The spyglass cholangioscopy system is very safe compared to the earlier cholangioscopes; however, there remains a minimal risk of complications which include cholangitis, pancreatitis, bacteremia, abdominal pain, and nausea.