Experiencia en colangioscopia digital peroral con SpyGlass DS en diferentes centros de referencia en gastroenterología y endoscopia digestiva en Colombia: Serie de casos

Cristian Flórez Sarmiento; Viviana Parra Izquierdo; Juan Sebastian Frías Ordoñez; Julián Parga Bermúdez; Jesús David Castillo; Charlyn Stefani Rodríguez; Víctor Rodríguez

doi:10.47892/rgp.2022.423.1356

Autores/as

Cristian Flórez Sarmiento Gastroadvanced IPS, Bogotá, Colombia http://orcid.org/0000-0002-3822-9287
Viviana Parra Izquierdo Gastroadvanced IPS, Bogotá, Colombia. Hospital Internacional de Colombia, Bucaramanga, Colombia http://orcid.org/0000-0003-2361-1018
Juan Sebastian Frías Ordoñez Departamento Epidemiología. Universidad El Bosque. Bogotá D.C. Colombia http://orcid.org/0000-0003-2735-2922
Julián Parga Bermúdez Gastroadvanced IPS, Bogotá, Colombia http://orcid.org/0000-0001-8988-2887
Jesús David Castillo Gastroadvanced IPS, Bogotá, Colombia http://orcid.org/0000-0002-1068-6961
Charlyn Stefani Rodríguez Gastroadvanced IPS, Bogotá, Colombia. http://orcid.org/0000-0001-9851-3741
Víctor Rodríguez Gastroadvanced IPS, Bogotá, Colombia http://orcid.org/0000-0002-8583-9977

DOI:

https://doi.org/10.47892/rgp.2022.423.1356

Palabras clave:

Enfermedades de las Vías Biliares, Enfermedades, Tratamiento de los Conductos Biliares, Colangiopancreatografia Retrógrada Endoscópica, Endoscopia, Diagnóstico,

Resumen

SpyGlass DS es un sistema de colangioscopia peroral, asociado a mejor calidad de imagen y configuración. Actualmente, existe diversidad en su uso y escasa información sobre su implementación, incluyendo resultados clínicos y eventos adversos. Describir la experiencia de uso del SpyGlass DS en varios centros de referencia en gastroenterología en Colombia, mencionando eficacia y posibles eventos adversos. Este es un estudio observacional (serie de casos). La principal indicación fue coledocolitiasis (n:204), seguida de estenosis biliar (n:40) y pancreatolitiasis (n:16). 49,2% fueron hombres, edad media de 58,6 años, clínicamente con predominio de dolor abdominal (80,5%) e ictericia (86,1%). Todos los casos presentaron diagnóstico por imagen previo (tomografía computarizada, resonancia magnética o ecografía), 98,07% colangiopancreatografía retrógrada endoscópica previa (n:255) y 75% stent plástico biliar. Se utilizó láser en 78/220 pacientes y litotricia electrohidráulica en 142/220 pacientes, con tasas de resolución en una sola sesión 96,15% y 95,07%, respectivamente. Siete casos requirieron segunda sesión de litotricia y 3 pacientes requirieron manejo quirúrgico, uno por pancreatolitiasis con páncreas divisum de base y 2 por hepatolitiasis. 40/260 pacientes presentaron estenosis biliar, 32/40 con hallazgos malignos (colangiocarcinoma) y 8/40 con patología benigna (colangitis esclerosante primaria, cambios inflamatorios inespecíficos) tras estudios histopatológicos. Como complicaciones, se registraron 6 casos de bacteriemia (2,5%), siendo más frecuentes en casos de estenosis. La estancia media postoperatoria fue 2,04 días. Concluimos que el uso del SpyGlass DS es factible en nuestro medio, siendo eficaz para diagnóstico y tratamiento de lesiones biliares, y con bajo riesgo de eventos adversos.

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