Background/Objectives: the aim of this study was to evaluate the safety and efficacy of percutaneous transhepatic lithotripsy using the SpyGlassDSTM cholangioscopy system for the treatment of difficult stones. Methods: Retrospectively, all patients treated with percutaneous transhepatic lithotripsy using SpyGlassDSTM cholangioscopy system were analyzed. As primary outcome measures, the following data were assessed: the presence of a previous history of the hepatobiliary disease, location of stones, reasons for the choice of the procedure, previous balloon bilioplasty, type of pre-procedural imaging, procedural time, technical success, clinical success, and post-procedural complications (according to CIRSE classification). Clinical success was considered "primary" when achieved with a single treatment, and "secondary" if more than one treatment was required in the duration of follow-up. Results: 10 patients (6 males and 4 females, mean age = 64 years, SD = 22), all with cholangitis due to gallstones, underwent 11 PTL procedures using SpyGlassDSTM. Technical and clinical successes were achieved in all patients (100%). Primary success was observed in 4/10 (40%) patients, while the remaining 6/10 (60%) patients undergoing re-treatment, and all showed secondary success (100%). No periprocedural complications were observed. In 10/11 procedures (90%), no relevant adverse events were recorded within the first thirty days of follow-up. In 1/11 case (9%), mild complications (grade I according to CIRSE classification) were registered in the following days after the procedure (<30 days). Conclusions: in conclusion, the treatment of percutaneous transhepatic lithotripsy using SpyGlassDSTM cholangioscopy of difficult stones has been demonstrated as efficient and safe treatment.
Diagnostics (Basel, Switzerland). 2025 Apr 22*** epublish ***
Salvatore Alessio Angileri, Giuseppe Pellegrino, Carolina Lanza, Jacopo Pozzi, Marco Costa, Matilde Pavan, Pierpaolo Biondetti, Serena Carriero, Velio Ascenti, Gaetano Valerio Davide Amato, Pierluca Torcia, Anna Maria Ierardi, Gianpaolo Carrafiello
Department of Diagnostic and Interventional Radiology, Foundation IRCCS Cà Granda-Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122 Milan, Italy., Department of Oncology and Hemayo-Oncology, Università degli Studi di Milano, 20122 Milan, Italy., Postgraduate School in Radiodiagnostics, Università degli Studi di Milano, 20122 Milan, Italy.